Neuroprotection against surgically induced brain injury

Abstract

Neurosurgical procedures are carried out routinely in hospitals across the world. Every neurosurgical procedure, regardless the purpose, involves a certain degree of brain injury that results from the procedure itself because of the unique nature of the nervous system. Brain tissue is at risk of injury by various means, including incisions and direct trauma, electrocautery, hemorrhage, and retractor stretch. Fortunately there are various substances with neuroprotective effect on human brain, with different molecular pathways, which can be used, together with surgical protective measures, as therapeutically drugs preventing brain damage during surgery. Among them steroids, some anesthetic agents intraoperative hypothermia are suggested to provide cerebral neuroprotection, but also new established therapeutic agents, such as erythropoietin and statins, Src tyrosine kinase inhibitor, used clinically in patients for different nonneurological disorders, which have also shown promise as neuroprotectants in experimental studies. Any form of pretreatment that proved effective when used before brain injury may have a significant impact on patient recovery and outcome of procedures. This review is intended to raise the question about neuroprotection methods and agents against surgically induced brain injury available today in neuroscience scientific community and stimulate discussions about future approaches and therapies.

Keywords

• surgery
• brain injury
• neuroprotection