Pharmacological Neuroprotection

Abstract

Neuroprotection involves provision of the means to prevent or minimize injury to neurons. When confronted with the need for neuroprotection, a clear understanding of the underlying mechanisms of both injury and treatment are required to decide on the best approach. The concept of an ischaemic penumbra and the chemical brain retractor concept have aided the emergence of neuroprotective strategies. These strategies play important roles in perioperative situations such as cardiopulmonary bypass, deep hypothermic circulatory arrest, carotid surgery, and cerebral aneurysm surgery. Subarachnoid haemorrhage, stroke, brain trauma, spinal trauma, induced hypotension, and post cardiac arrest resuscitation, are other clinical situations where protecting the central nervous system is a priority. Drugs such as barbiturates, etomidate, propofol, isoflurane, methylprednisolone, tirilazad mesylate, nimodipine, nicardipine, and mannitol are used for protecting the nervous tissue.