Practice Points:
- The evolution of injury following hypoxic-ischemic injury involves multiple mechanisms and progresses over a prolonged period of time.
- Cell death often presents as a continuum between early necrosis and later apoptosis, involving a balance between early biophysical damage and failure of oxidative metabolisms and activation of pro- grammed cell death pathways.
- Very delayed necrotic cell death can also be mediated by recently described cell death pathways.
- While hypothermia needs to be initiated as early as possible, some delayed therapies are beginning to show promise in enhancing repair and long-term functional outcomes.
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