CEREBRAL ISCHEMIA: CAUSES, DEVELOPMENTAL MECHANISMS AND PREVENTIVE APPROACHES ABSTRACT
Keywords:
miya ishemiyasi; patobiologik mexanizmlar; serebral perfuziya; ekzitotoksiklik; neyroprotektsiya; insultni bartaraf etish; ateroskleroz; atrial fibrillyatsiya; mayda tomir kasalligi; serebrovaskulyar patologiyaAbstract
This review consolidates contemporary evidence on the principal pathobiological pathways of ischemic stroke — encompassing thromboembolic occlusion, atherosclerotic plaque vulnerability, and microangiopathy of penetrating arteries — while critically appraising primary, secondary, and emerging preventive frameworks grounded in molecular evidence. Once cerebral perfusion reserve descends below 10 mL/100 g/min, aberrant neurotransmitter release is triggered, initiating a cascading pathochemical sequence: adenosine triphosphate depletion, impaired transmembrane ionic homeostasis, mitochondrial apoptotic activation, and necrobiotical cellular demise. Activation of the NLRP3 inflammasome, phenotypic reprogramming of resident microglia, and transendothelial migration of neutrophil granulocytes into cerebral parenchyma collectively drive progressive infarct core enlargement. Preventive interventions supported by rigorous clinical evidence encompass: systolic blood pressure reduction (yielding a 35–40% decline in stroke incidence), stabilization of atheromatous plaques via statins, administration of novel direct oral anticoagulants in atrial fibrillation (RE-LY and ROCKET-AF trials), and multidimensional risk factor management
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