IGF-1 and its binding proteins and receptors are induced within damaged brain regions following ischemia and exogenous administration of IGF-1 after injury protect grey and white matter and leads to improved long-term neurological function.The limited window of opportunity for treatment with IGF-1 can be extended by spontaneous mild post-hypoxic hypothermia,probably due to delayed evolution of apoptotic processes.Its neuroprotective effects are clearly mediated by IGF-1 receptors and binding proteins.However,the poor central uptake of IGF-1 and its potential mitogenic nature prevent its clinical application.