**7. Final remarks and future directions**

In addition to continuing the search for pharmacological agents that allow the neuroprotection and neurorestoration of tissue affected by cerebral ischemia, the development of physical therapy and diet modification offers new horizons that have shown satisfactory results in the clinical setting in short times. However, it has not yet been possible to establish a protocolized treatment that can be added to the health care guidelines; so it is important to continue exploring all possible strategies to improve the quality of life of people who have suffered a cerebral infarction and that of their caregivers.

**References**

June 2018]

editor. 2017

634-634A

jpts.27.1665

**291**

[1] WHO. The Top Ten Causes of Death. Fact Sheet. World Health Organization. Available from: https://www.who.int/ en/news-room/fact-sheets/detail/thetop-10-causes-of-death [Accessed: 14

*DOI: http://dx.doi.org/10.5772/intechopen.91282*

*Available Therapeutics after a Stroke: Current and Promising Options*

2018;**25**(1):35-40. DOI: 10.1111/

[10] Lo EH, Dalkara T, Moskowitz M. Neurological diseases: Mechanisms, challenges and opportunities in stroke. Nature Reviews Neuroscience. 2003;

[11] Obel LF et al. Brain glycogen-new perspectives on its metabolic function and regulation at the subcellular level. Frontiers in Neuroenergetics. 2012;**4**:3. DOI: 10.3389/fnene.2012.00003

[12] Xing C, Arai K, Lo EH, Hommel M. Pathophysiologic cascades in ischemic stroke. International Journal of Stroke. 2012;**7**(5):378-385. DOI: 10.1111/j.

[13] Song M, Yu SP. Ionic regulation of cell volume changes and cell death after ischemic stroke. Translational Stroke Research. 2014;**5**(1):17-27. DOI: 10.1007/s12975-013-0314-x

[14] Curcio M, Salazar IL, Mele M, Canzoniero LM, Duarte CB. Calpains and neuronal damage in the ischemic brain: The swiss knife in synaptic injury. Progress in Neurobiology. 2016;**143**: 1-35. DOI: 10.1016/j.pneurobio.2016.

[15] Lee BI, Lee DJ, Cho KJ, Kim GW.

endonuclease G and subsequent DNA fragmentation after transient focal cerebral ischemia in mice. Neuroscience

[16] Coultrap SJ, Vest RS, Ashpole NM, Hudmon A, Bayer KU. CaMKII in cerebral ischemia. Acta Pharmaceutica Sinica B. 2011;**32**(7):861-872. DOI:

Hatcher JF. Phospholipase A2, reactive

Early nuclear translocation of

Letters. 2005;**386**(1):23-27. DOI: 10.1016/j.neulet.2005.05.058

[17] Muralikrishna Adibhatla R,

10.1038/aps.2011.68

1747-4949.2012.00839.x

06.001

ene.13409

**4**(5):399-415

[2] IHME. Global Deaths Rate per 100k, Stroke. G. H. D. Exchange and (GHDx),

[3] Johnson W, Onuma O, Owolabi M, Sachdev S. Stroke: A global response is needed. Bulletin of the World Health Organization. 2016;**94**(9):

[4] Rubio Ballester B et al. A critical time window for recovery extends beyond one-year post-stroke. Journal of Neurophysiology. 1 July 2019;**122**(1): 350-357. DOI: 10.1152/jn.00762.2018

[5] Silva SM, Corrêa FI, Faria CDCdM, Buchalla CM, Silva PF d C, Corrêa JCF. Evaluation of post-stroke functionality based on the international classification of functioning, disability, and health: A proposal for use of assessment tools. Journal of Physical Therapy Science. 2015;**27**(6):1665-1670. DOI: 10.1589/

[6] Balasubramanian S. Motor Impairments Following Stroke [Internet]. Unpublished; 2015. DOI:

10.13140/RG.2.1.3349.6804

[8] Wahlgren N, Ahmed N.

[7] RTI. Cardiovascular Disease Costs will Exceed \$1 Trillion by 2035. Available from: https://www.rti.org/news/card iovascular-disease-costs-will-exceed-1-trillion-2035 [Accessed: 14 June 2019]

Neuroprotection in cerebral ischaemia: Facts and fancies—The need for new approaches. Cerebrovascular Diseases (Basel, Switzerland). 2004;**17**:153-166

[9] Meschia JF, Brott T. Ischaemic stroke. European Journal of Neurology.
