Acidotoxicity trumps excitotoxicity in ischemic brain

Plum entitled his 1982 Wartenberg Lecture "What Causes Infarction in Ischemic Brain?"1 This question remains incompletely answered 2 decades later, during which excitatory amino acids and calcium toxicity have been central research and therapeutic targets. Recently, attention has returned to a central neurochemical feature of ischemic brain injury, acidosis, which was focused on in Plum's lecture. Targeting this effector of injury as therapy for brain ischemia now may be closer at hand and may result in robust neuroprotection. ©2006 American Medical Association. All rights reserved.