Abstract
A variety of approaches have been taken to protect the brain from ischemia in the field of intensive care. They are categorized into two strategies; one is non-drug therapy and the other is drug therapy. Eight strategies contained in the study of protection from neurodegeneration are keys to successful brain protection. They include (1) improved operative techniques, (2) control of blood pressure and intracranial pressure (ICP) and maintenance of cerebral perfusion, (3) development of new neuroprotective drugs for brain protection, (4) drug therapy based on therapeutic windows, (5) avoidance of perioperative hyperthermia and/or hyperglycemia, and implementation of postoperative hypothermia to prevent reperfusion injury, (6) utilization of a cerebral protection system in the body (ischemic tolerance phenomena), and (7) monitoring of brain function, search for new biomarkers, and further improvement of brain-oriented intensive care therapy. Finally, under the eighth strategy, it is assumed that neurorestorative approaches are taken in case cerebral dysfunction still remains, and that in the future, in combination with introduction of gene therapy, neural regeneration and functional recovery will be pursued while suppressing the onset of ischemic neuropathy completely or keeping it to a minimum.
