A stroke is an acute neurological injury resulting from ischemia or hemorrhage of the brain. Ischemia is caused by a decreased supply of arterial blood that carries sugar and oxygen to brain tissue. Hemorrhagic stroke is caused by intracerebral or subarachnoid bleeding and damages the brain directly at the site of bleeding by compressing the tissues surrounding it. Ischemic strokes can be embolic or thrombotic. The consequences of a thrombotic stroke are due to the formation of clots in the arterial blood vessel which supplies blood to the brain and can affect either large or small vessels. Small vessel disease affects the intracerebral arterial system. A stroke due to obstructions in these vessels is called a lacunar infarction. Lacunar infarcts are small, non-cortical infarcts (0.2 to 15 millimeters in diameter) caused by occlusion of a single penetrating branch of a large cerebral arterial blood vessel. Lacunar stroke has 5 classic syndromes and motor stroke is the most common syndrome. The typical presentation is hemiparesis of the face, arm, or leg on one side. The clinical symptoms of stroke are slurred speech, right hand numbness, weak right glove grip, and right-sided facial paralysis (health direct, 2014) and are the most common among strokes ischemic brain disease (Rathore, Hinn, Cooper, Tyroler, & Rosamond, 2002). Review Mechanisms of ischemic cell injury and death There is progressive vasoconstriction of arterioles until blood pressure exceeds the upper limit of autoregulation, followed by breakthrough vasodilation, increased cerebral blood flow, d dysfunction of the blood-brain barrier and cerebral edema (Rodriguez-Yanez et al., 2006). Cerebral ischemia results in severely ischemic tissue with failure of electrical activity and ion pumps (Rodriguez-Yanez et al., 2006). There is an increased release of glutamate, an excitatory amino acid, due to electrical failure. (Rodriguez-Yanez et al., 2006). Glutamate receptors are then activated and cause the opening of ion channels which allow potassium ions to leave the cell and sodium and calcium ions to enter. This has a number of physiological effects. The above events result in cell death, including ATP depletion, changes in ionic concentrations of sodium, potassium and calcium, increased lactate, acidosis, accumulation of oxygen free radicals, accumulation intracellular water and activation of proteolytic processes. (Deb, Sharma and Hassan, 2010). Around this is the penumbra (Rodriguez-Yanez et al., 2006). Different cell signaling pathways respond to calcium levels. The influx of calcium resulting from stimulation of glutamate receptors leads to their activation.