Recent advances in the treatment of postischemic encephalopathy. A review

Irreversible brain damage after a short period of cerebral ischemia is a clinical drama. Not neuronal dead in se, but a hemodynamic event, described as no reflow phenomenon (NRF) seems to be the primary pathogenetic factor towards fatal outcome. A combination of four flow promoting therapeutic measures (heparinisation, hemodilution, systemic arterial hypertension and brainflushing with dextran 40) greatly improves recovery of the brain function after 12 min. of cardiac arrest in dogs. Short acting barbiturates provide remarkable amelioration of postischemic encephalopathy in the monkey.