The ischemic (ischaemic) cascade is a series of biochemical reactions that are initiated in the brain and other aerobic tissues after seconds to minutes of ischemia (inadequate blood supply).
[1] This is typically secondary to stroke, injury, or cardiac arrest due to heart attack.
Most ischemic neurons that die do so due to the activation of chemicals produced during and after ischemia.
[2] The ischemic cascade usually goes on for two to three hours but can last for days, even after normal blood flow returns.
Over 150 cerebroprotectants have been tested in clinical trials, leading to the approval of tissue plasminogen activator (also known as tPA, t-PA, rtPA, Activase, or Alteplase or Actilyse)[7] in the US and other countries, and edaravone (Radicut) in Japan.