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Despite these facts, the ischemic cascade can be generally characterized as follows:
1. Lack of oxygen causes the neuron's normal process for making ATP for energy to fail.
2. The cell switches to anaerobic metabolism, producing lactic acid.
3. ATP-reliant ion transport pumps fail, causing the cell to become depolarized, allowing ions, including calcium (Ca++), to flow into the cell.
4. The ion pumps can no longer transport calcium out of the cell, and intracellular calcium levels get too high.
5. The presence of calcium triggers the release of the excitatory amino acid neurotransmitter glutamate...
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