Review article
Neuroprotection in ischemic stroke – successes and fails

Ischemic stroke is the leading medical cause of mortality and neurological disability in adult population. Large progress was made by introducing recombinant tissue activator (rt-PA) but according to very strict inclusion criteria, its use is limited to small number of patients. Effective, well-tolerated treatments are needed to decrease disability and improve patients’ prognosis. The idea of neuroprotective agent is that it interferes with mechanisms involved in ischemic cascade. Fine results obtained with neuroprotectants in models of ischemia are not reproducible in clinical trials. To improve quality of experimental studies, STAIR (Stroke Therapy Academic Industry Roundtable) introduced recommendations for preclinical drug testing. NXY-059 was the only drug which fulfilled the STAIR recommendation and much was expected with its use. However the results of large, randomized clinical trials were very disappointed and up till now no neuroprotective drug has been introduced to the market.