The Efficacy of Citroline in the Treatment of Ischemic Stroke and Primary Hypertensive Intracereral Hemorrhage; A Review Article

Stroke is a medical emergency with a mortality rate higher than most forms of cancer. It is the second leading cause of death in developed countries and the most common cause of serious, long-term disability in adults. Primary intracerebral hemorrhage (ICH) is a major clinical problem that accounts for 15% of all acute stroke hospitalizations. Currently, there is no medical therapy available for these patients, with options being limited to supportive care or invasive neurosurgical evacuation. The damage induced by an ICH appears to be related to a combination of different factors. In addition to direct mechanical disruption from the hematoma, surrounding injury secondary to edema formation and ischemia are contributing factors for brain injury following ICH. Citicoline (cytidine-5-diphosphocholine) is an essential precursor for the synthesis of phosphatidylcholine that is key component of cell membranes. Citicoline is a naturally occurring endogenous compound. For clinical use, the sodium salt of this compound usually utilized. During ischemia, phosphatidylcholine is broken down into free fatty acids, which in turn are used to generate free radicals that potentiate ischemic injury. Citicoline is a neuroprotectant drug with some beneficial effects in human ischemic stroke and primary intracerebral hemorrhage (ICH) with an excellent safety profile. In the current paper, we review published papers regarding use of citicoline in the treatment of human ischemic stroke and primary intracerebral hemorrhage (ICH).