The problem of cerebral resuscitation is one of tremendous scope for (at least) two reasons:
The problem is incredibly complex. As
you will see, neuronal death after an ischemic insult is a hideously
complicated phenomenon, involving many damaging processes. These
damaging processes are highly interlocked, to the point where isolating
the effects of one process to the exclusion of others is almost
impossible. The study of ischemic brain damage boils down to the
science of what happens when the most complex object in the known
universe gets sick.
The problem involves incalculable human suffering and huge costs to society.
Stroke effects up to 700,000 people a year in the US alone, and 70,000
a year survive a cardiac arrest, most with significant brain damage.
The costs for stroke alone approach $60 billion.
It is my personal and somewhat
biased opinion that cerebral resuscitation is a problem of
unsurpassed importance for the emergency physician. The modern
physician has an unprecedented ability to revive the arrested heart,
and stabilize patients with shock and head trauma, and there's every reason to believe we'll continue to make progress in resuscitology -- slow, painfully slow -- but steady. What good, though, is a resuscitologist when his/her
ministrations only increase the number of human vegetables? We need a
clinically effective approach to brain preservation, as physicians and
as a specialty.