J Anesth Perioper Med. 2017;4(2):76-86. https://doi.org/10.24015/ebcmed.japm.2017.0022

Ischemic Stroke Mechanisms, Prevention, and Treatment: The Anesthesiologist's Perspective

Myles R. McCrary1*, Song Wang1,2*, and Ling Wei1,2

From 1Department of Anesthesiology, Emory University School of Medicine, Atlanta, USA; 2Department of Neurology and Laboratories of Stem Cell Biology and Regenerative Medicine, Neurological Disease Center and Experimental Research Center, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

*Contributed equally to this work.

Correspondence to Dr. Ling Wei at lwei7@emory.edu.

EBCMED ID: ebcmed.japm.2017.0022 DOI: 10.24015/ebcmed.japm.2017.0022


Abstract

Aim of review
Stroke remains a leading cause of mortality and morbidity. After decades of extensive research, we have gained a detailed understanding of the cellular and molecular mechanisms governing stroke pathophysiology. Despite these advances, few novel and effective treatments have been discovered. Understanding the mechanisms that underlie ischemic brain damage may direct research on future therapies.

Methods
We reviewed the available literature pertaining to stroke pathology in the past decades and provided brief summaries of the important basic and clinical stroke findings.

Recent findings
This review provided an overview of basic stroke mechanisms and highlighted the main events and processes that lead to cellular demise. We concluded with stroke preventative measures and treatment, highlighting the role of anesthesiologists in preventing perioperative stroke.

Summary
An appreciation of our current understanding of stroke pathology may inform the development of new therapies or preventative measures for stroke, such as anesthetic preconditioning, and lead to optimal perioperative management of patients at high risk for stroke.

Article Type
Original Article

Declaration of Interests
The authors have no conflicts of interest for this work to declare.

Acknowledgements
This study was supported by grants (NS062097 and NS091585 to L Wei) from the National Institutes of Health.

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