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*Aconitum coreanum* extract is a traditional herbal medicine derived from the dried tuberous root of the plant *Aconitum coreanum* (Lévl.) Rapaics. It is currently being investigated in preclinical research for its neuroprotective potential in cerebral ischemic stroke (CIS). The extract, which contains active C-20 and C-19 diterpenoid alkaloids, has demonstrated the ability to reduce infarct size, improve neurological function, and suppress neuronal apoptosis in animal models such as rats and gerbils. Its mechanism of action is multi-faceted, involving the inhibition of autophagy via the regulation of the AMPK/mTOR/ULK1 signaling pathway and the promotion of cell survival through the PI3K/Akt pathway. Additionally, it exerts antioxidant effects by modulating the KEAP1/NRF2 pathway, thereby reducing oxidative stress and inflammatory markers associated with ischemic injury.
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