[Neuroprotection in neurocritical care]

Area of Science:

• Neurocritical care medicine
• Intensive care medicine
• Neurology

Background:

• Secondary brain damage is a major concern in acute brain injury (stroke, hemorrhage, resuscitation).
• Pathophysiology varies by injury type, necessitating tailored neuroprotective strategies.
• Common mechanisms include reperfusion injury, blood-brain barrier disruption, and excitotoxicity.

Purpose of the Study:

• To review the relevance of neuroprotective measures in neurocritical care.
• To describe general and specific pathophysiological mechanisms of acute brain injury.
• To discuss treatment options for brain pressure crises, anemia, and glucose dysregulation.

Main Methods:

• Literature review focusing on neuroprotection in acute brain injury.
• Discussion of pathophysiological mechanisms and clinical management strategies.
• Emphasis on therapeutic hypothermia as a key neuroprotective intervention.

Main Results:

• Physiologically normal conditions favor brain recovery after injury.
• Management of intracranial pressure, anemia, hyperglycemia, and hypoglycemia are crucial.
• Therapeutic hypothermia demonstrates significant clinical efficacy in neuroprotection.

Conclusions:

• Neuroprotection requires addressing specific injury mechanisms and maintaining physiological balance.
• Therapeutic hypothermia is a vital, clinically proven neuroprotective measure, especially post-cardiac arrest.
• Individualized treatment approaches combined with general supportive care improve outcomes in acute brain injury.