Acute central nervous system (CNS) injury, eg, ischemia, trauma, results in the almost immediate death of neurons. Surrounding tissue is at risk for further cell death. This circumjacent tissue has been labeled tissue-at-risk or the ischemic penumbra. A complex interrelated series of pathophysiological events occurs in this vulnerable tissue which, if not interrupted, will inexorably progress to tissue necrosis (secondary injury).1 A discussion of the various factors involved in this secondary injury cascade are beyond the scope of this chapter. However, one of the pathophysiological events believed to play a crucial role in this injury cascade is free radical-mediated lipid peroxidation.
KeywordsPlacebo Ischemia Cortisol Respiration Glucocorticoid
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