Selective Vulnerability of the Brain: New Insights into the Pathophysiology of Stroke
Authors: Robert C. Collins
Journal: Annals of Internal Medicine (1989)

UCLA Conference15 June 1989Selective Vulnerability of the Brain: New Insights into the Pathophysiology of StrokeRobert C. Collins, MD, Bruce H. Dobkin, MD, Dennis W. Choi, MD, PhDRobert C. Collins, MDSearch for more papers by this author, Bruce H. Dobkin, MDSearch for more papers by this author, Dennis W. Choi, MD, PhDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-110-12-992 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptStroke is a major cause of morbidity and mortality in the United States with 250 000 cases per year. Cerebral ischemia is the largest category of stroke with cardiac arrest, profound hypotension, and vascular occlusion the principal causes. Traditional approaches to the treatment of ischemic stroke focus on maintaining cardiac output, blood pressure, cerebral blood flow, and on preventing thrombosis. Recently, attention has been focused on developing new therapies that are directed toward abnormal biochemical events at excitatory synapses. Ischemia causes impairment of brain energy metabolism and the release of excessive amounts of glutamate into the extracellular space. This process...References1. Olney J. Neurotoxicity of excitatory amino acids. In: McGeer P, Olney JW, eds. Kainic Acid as a Tool in Neurobiology. New York: Raven Press; 1978:95-121. Google Scholar2. OlneySharpeDeGubareff JLT. Excitotoxic amino acids [Abstract]. Neuroscience. 1975;1:371. Google Scholar3. Collins R. Selective vulnerability of brain: new insights from the excitatory synapse. Metab Br Dis. 1986;1:231-40. CrossrefMedlineGoogle Scholar4. LevyCaronnaSingerLapinskiFrydmanPlum DJBRHF. Predicting outcome from hypoxic-ischemic coma. JAMA. 1985;253:1420-6. CrossrefMedlineGoogle Scholar5. BrierleyMeldrumBrown JBA. The threshold and neuropathology of cerebral "enoxic-ischemic" cell change. 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Selective vulnerability of the brain: new insights into the pathophysiology of stroke. Ann Intern Med. 1989;110:992-1000. 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