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The History of Clinical Neuroprotection Failure

Abstract

Neuroprotection in stroke treatment refers to a group of treatments and drugs aimed to antagonize the biochemical and molecular processes that lead to irreversible ischemic damage. In recent years, several clinical studies have been conducted to test the efficacy of several promising molecules with different mechanisms of action. However, the results obtained from preclinical studies (on in vitro models or on animals), despite having provided excellent results, making the goal of stroke neuroprotection at least achievable, were accompanied by a high failure rate. The reasons for these failures are linked to the unbridgeable difference between the animal and human models and to the marked heterogeneity of stroke in humans. Although future perspectives are encouraging, other techniques such as neuroprotectant cocktails, reperfusion, improving angiogenesis and collateral circulations, and infarction prevention, may represent a goal in stroke neuroprotection.

Table of Contents: History of Stroke

The Turning Point in Stroke Investigation for Neurologists

MPMaurizio PaciaroniMaurizio Paciaroni
JBJulien BogousslavskyJulien Bogousslavsky

Stroke and the Arts

BPBartlomiej Piechowski-JozwiakBartlomiej Piechowski-Jozwiak
JBJulien BogousslavskyJulien Bogousslavsky

History of Cardiac Embolism

GSGiacomo StaffolaniGiacomo Staffolani
MGMichela GiustozziMichela Giustozzi
MPMaurizio PaciaroniMaurizio Paciaroni

History of “Lacunar Infarction”

GBGiacomo BasoGiacomo Baso
LPLeonardo PantoniLeonardo Pantoni

History of Stroke Imaging

MHMichael G. HennericiMichael G. Hennerici
SMStephen MeairsStephen Meairs

Stroke Units, Stroke Registries and Acute Management (R)evolutions

CCCarmen CalvelloCarmen Calvello
LGLucia GentiliLucia Gentili
RRRoberta RinaldiRoberta Rinaldi

Stroke Rehabilitation from a Historical Perspective

MAMonica AcciarresiMonica Acciarresi
MZMauro ZampoliniMauro Zampolini