Nothing here gives any sense of urgency because we don't know how much less than 1.9 million neurons are dying every minute. Any continuing death of neurons needs to be stopped. Neuroprotection gives NO sense of urgency. I bet they don't even know how long the neuronal cascade of death continues after the blockage or bleed is stopped.
http://link.springer.com/chapter/10.1007/978-3-319-45345-3_1
Abstract
Translational
neuroprotection research is currently undergoing a rebirth, a much
needed revival, in part due to the efficacy of both thrombolytic and
endovascular procedures in subpopulations of ischemic stroke patients.
Stroke is currently treated with the Food and Drug administration
(FDA)-approved thrombolytic, tissue plasminogen activator (rt-PA), and
can be treated with endovascular approaches using the MERCI stent
retriever or the Solitaire FR stent retriever, with the application of
thrombolytic (i.e., rt-PA or urokinase) prior to embolectomy for rt-PA
eligible patients. Moreover, from retrospective analysis in rt-PA
ineligible stroke patients, embolectomy alone has proven safe and
beneficial if completed within 6 h.
Despite many decades
of research into the identification and translational development of
neuroprotective compounds, only few strategies have progressed into
appropriately designed unbiased, randomized, placebo-controlled clinical
trials. The FDA has still not been able to afford approval to a
neuroprotectant to treat ischemic disease, primarily because of
exaggerated overestimation of efficacy in rodent models that did not
translate into efficacy in humans. During the process of developing
neuroprotective compounds to treat ischemic diseases, stroke in
particular, numerous problems have emerged including the absolute
failure to translate preclinical animal efficacy into efficacy in stroke
victims, and in some cases, both significant adverse events and
unforeseen toxicities have hindered drug development and approval. This
chapter describes successes and failures in the stroke neuroprotection
research, provides a comprehensive tabulated assessment of select
neuroprotectants that have been tested in clinical trials, and proposes
recommendations and essential checklists to both guide and improve the
quality of science being conducted in preclinical and translational
laboratories worldwide. The ultimate goal is to reap the benefits of a
worldwide concerted neuroprotection research effort to provide superior
care to stroke victims.
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