With as many as 500,000 new strokes per year in the United States, the need for safe and effective therapy of these patients is evident. The area in which the greatest impact has been made is in the development of prophylactic treatments for patients at risk of stroke. Aspirin, long the mainstay of stroke management, has repeatedly been shown to reduce the risk of cerebral ischemia in patients who have had a transient ischemic attack (TIA) or minor stroke and is first-line therapy for these patients. Either 325 mg or 975 mg of aspirin may be used. Ticlopidine (250 mg twice daily) is a new antiplatelet agent that is recommended for the prophylaxis of stroke in patients who cannot tolerate or who are resistant to aspirin therapy. The surgical procedure, carotid endarterectomy, has been shown to reduce the stroke rate in symptomatic patients, with between 70% to 99% stenosis of a carotid artery. The use of warfarin has been shown to be extremely useful in patients with atrial fibrillation for prevention of recurrent embolic events. The use of pharmacological agents in the acute treatment of the ischemic stroke patient has not yet been proven successful. It is hoped that with the trend towards hyperacute (less than 6 hours) intervention, investigators may be successful in finding an agent to decrease the ultimate neurological deficit due to stroke. Some of the more promising agents are thrombolytics, glutamate antagonists, and aminosteroids. Future research in cerebral ischemia will undoubtedly improve the prognosis of stroke patients.
Mitochondrial superoxide production and MnSOD activity following exposure to an agonist and antagonists of ionotropic receptors in rat brain
