[Problems in brain protection].

The main aim of intensive care in acute head injury and in the postoperative period is to prevent, detect, and revert a secondary neuronal injury. To maintain the optimum systemic and cerebrovascular functions can substantially promote this aim achievement. There are some new neuroprotective interventions that are currently under investigation. Although the major focus of recent cerebral protection researches has been on the development of receptor-specific drugs, this effort has resulted in better outcomes. At present, patients are well served by using more traditional techniques to prevent and treat cerebral ischemic events. Initial therapy should include interventions to improve cerebral perfusion and the oxygen-carrying capacity of blood. Once this is accomplished, measures should be made to monitor blood glucose concentrations and to treat fever. General anesthetic choice may be of great importance in monitoring intracranial pressure and seizure activity. However, if direct cerebral protection is desired, a barbiturate should be the anesthetic of choice. All these measures should increase the chance of patients to neurologically recover following hypoxia and ischemia.