Neuroprotective potential of indian herbs in ischaemic stroke: a comprehensive review of pharmacological insights, therapeutic gaps, and future directions.

Stroke is the second most common cause of mortality worldwide and a major contributor to acquired disability. Current treatment options, such as recombinant tissue plasminogen activator (r-tPA), are restricted by a narrow therapeutic window and an increased risk of cerebral haemorrhage. Herbal medicines demonstrate considerable potential in the management of ischaemic stroke by modulating key pathological processes, including blood-brain barrier disruption, neuroinflammation, apoptosis, oxidative stress, glutamate excitotoxicity, and mitochondrial dysfunction. This review identified the gaps from preclinical and clinical studies on neuroprotective plants and their phytoconstituents from India, with particular emphasis on the cellular, molecular, and genetic mechanisms implicated in stroke pathology. Furthermore, it evaluates the strengths and limitations of plant extracts, bioactive compounds, and formulations employed in ischaemic stroke therapy. Identified research gaps include insufficient long-term safety data, limited pharmacokinetic insights, and inadequate delivery systems. These highlight the need for advanced investigations to optimise formulation strategies, dosing regimens, and clinical translation. Collectively, these insights provide a basis for the development of effective, natural therapeutic approaches for ischaemic stroke.