This chapter focuses on the measures to reduce structural damage and improve functional outcome of the brain, which depends on various factors. Various stroke risk factors, including hypertension, diabetes, obesity, smoking, and surgical procedures, are a few targeted factors discussed as preventive measures. In the area of traumatic brain injury (TBI), the use of automobile seat belts and airbags, and the use of motorcycle helmets, can help prevent or limit irreversible damage. However, after the primary insult has occurred, strategies, including intensive care procedures, to limit secondary insults and the use of protective strategies to inhibit secondary injury mechanisms may potentially limit damage and improve outcome. Although the location and severity of the primary insult are important factors to determine the impact of the individual injury process, excitotoxicity, calcium-mediated events, free radicals, mitochondrial damage, inflammation, and apoptosis are commonly discussed as possible targets for therapeutic interventions. Pharmacological treatments targeting specific injury cascades, and the use of therapeutic hypothermia, have provided compelling evidence for neuroprotection in preclinical studies. Nevertheless, few agents have been successfully moved to the clinic, and currently no pharmacological treatments have been proven to protect against the detrimental consequences of TBI.
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