Combination of Therapeutic Hypothermia and other Neuroprotective Strategies after an Ischemic Cerebral Insult
Joline Goossens and Said Hachimi-IdrissiAffiliation:
Critical Care Department and Cerebral Resuscitation Research Group, Ghent University,De Pintelaan 185, 9000 Ghent, Belgium.
AbstractAbrupt deprivation of substrates to neuronal tissues triggers a series of pathological cascades that lead to cell death. This series of destructive events are referred to as the ischemic cascade. The last two decades, several pharmacological and non-pharmacological neuroprotective strategies were developed to attenuate or block this cascade after an ischemic stroke. The most promising neuroprotectant so far is therapeutic hypothermia andits beneficial effect has inspired researchers to further augment its protective benefits by combining it with other neuroprotective agents. This review provides an overview of all strategies that have combined therapeutic hypothermia with other neuroprotective agents in rodent models of focal cerebral ischemia. Adistinction is made between drugs interrupting only one event of the ischemic cascade from those mitigating different pathways and having multimodal effects.Also the combination of therapeutic hypothermia with hemicraniectomy, gene therapy and protein therapy are briefly discussed.Furthermore, combination therapiesthat have been studied in a clinical setting will also be reviewed.
Acute ischemic stroke, clinical, combination therapy, experimental, human, hypothermia, neuroprotection, rodent
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