In search of clinical neuroprotection after brain ischemia: the case for mild hypothermia (35°C) and magnesium

Bruno Meloni, Kym Campbell, H. Zhu, Neville Knuckey

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45 Citations (Scopus)

Abstract

Background and Purpose—Brain injury after stroke and other cerebral ischemic events is a leading cause of death anddisability worldwide. Our purpose here is to argue in favor of combined mild hypothermia (35°C) and magnesium asan acute neuroprotective treatment to minimize ischemic brain injury.Methods and Results—Drawing on our own experimental findings with mild hypothermia and magnesium, and in light ofthe moderate hypothermia trials in cardiac arrest/resuscitation and magnesium trials in ischemic stroke (IMAGES,FAST-Mag), we bring attention to the advantages of mild hypothermia compared with deeper levels of hypothermia, andhighlight the existing evidence for its combination with magnesium to provide an effective, safe, economical, and widelyapplicable neuroprotective treatment after brain ischemia. With respect to effectiveness, our own laboratory has shownthat combined mild hypothermia and magnesium treatment has synergistic neuroprotective effects and reduces braininjury when administered several hours after global and focal cerebral ischemia.Conclusions—Even when delayed, combined treatment with mild hypothermia and magnesium has broad therapeuticpotential as a practical neuroprotective strategy. It warrants further experimental investigation and presents a good casefor assessment in clinical trials in treating human patients after brain ischemia.
Original languageEnglish
Pages (from-to)2236-2240
JournalStroke
Volume40
Issue number6
DOIs
Publication statusPublished - 2009

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