THE CURRENT STATUS OF NEURONAL PROTECTIVE THERAPY - WHY HAVE ALL NEURONAL PROTECTIVE DRUGS WORKED IN ANIMALS BUT NONE SO FAR IN STROKE PATIENTS

The implication of several recent reviews and the subtitle of this paper is that animal models may not be relevant to human stroke. I will review neuronal protective therapy and how animal models have helped us unravel the biochemical abnormalities occurring as a result of cerebral ischemia and upon which neuronal protective therapies are based. However, I will also discuss the limits of animal models which have to be understood in relationship to the complexities of the clinical problem of stroke. Finally, I will conclude with a call for the international stroke community to take the information we have learned from these animal studies and begin planning now for a 'megatrial' of sufficient power to test these therapies alone and in combination.