EFFICACY OF NEUROPROTECTIVE DRUGS IN THE TREATMENT OF PATIENTS WITH ISCHEMIC STROKE: MODERN STRATEGIES

Аннотация

The problem of ischemic stroke remains highly relevant in modern neurology due to its high mortality, morbidity, and social burden. Although reperfusion therapy (thrombolysis, thrombectomy) is the gold standard, its application is limited by a narrow time window and a number of contraindications. This necessitates the development and implementation of effective neuroprotective drugs aimed at blocking the pathophysiological cascades of secondary brain damage. The aim of this article is to conduct a systematic analysis of modern neuroprotection strategies for ischemic stroke. Key pathogenesis targets are reviewed, including excitotoxicity, oxidative stress, inflammation, and energy failure. The evidence base for the efficacy and safety of both classical neuroprotectors (e.g., antioxidants, glutamate receptor blockers) and new, experimental approaches (agents affecting mitochondrial dysfunction, poly(ADP-ribose) polymerase inhibitors, stem cells) is analyzed. Special attention is paid to the reasons for the failure of translating preclinical results into clinical practice and the prospects for creating polymodal therapeutic regimens that combine reperfusion and neuroprotection.