The implication I get from this is that you are still allowing billions of neurons to die for each patient because you are doing nothing to stop the 5 causes of the neuronal cascade of death in the first week.
You've had thousands of failed neuroprotection trials because rodents don't have the same physiology as humans.
Drugs That Work In Mice Often Fail When Tried In People
The latest here:
The core/penumbra model: implications for acute stroke treatment and patient selection in 2021
This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi:10.1111/ene.14916
Abstract
Despite major advances in prevention, ischemic stroke remains one of the leading causes of death and disability worldwide. After centuries of nihilism and decades of failed neuroprotection trials, the discovery initially in non‐human primates and subsequently in man, that ischemic brain tissue termed the ischemic penumbra can be salvaged from infarction up to and perhaps beyond 24hrs after stroke onset has underpinned the development of highly efficient reperfusion therapies, namely intravenous thrombolysis and endovascular thrombectomy, which have revolutionized the management of the acute stroke patient. Animal experiments have documented that how long the penumbra can survive depends not only on time elapsed since arterial occlusion (‘Time is brain’), but also on how severely perfusion is reduced. Novel imaging techniques allowing to map the penumbra and the already irreversibly damaged core in the individual subject have documented that the time‐course of core growth at the expense of the penumbra widely differs from patient to patient, and hence that individual physiology should be considered in addition to time since stroke onset for decision‐making. This concept has been implemented to optimize patient selection in pivotal trials of reperfusion therapies beyond 3hr after stroke onset, and is now routinely applied in clinical practice, using computerized tomography or magnetic resonance imaging. The notion that in order to be both efficient and harmless, treatment should be tailored to each patient’s physiological characteristics represents a radical move towards precision medicine.
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