The chapter discusses the mechanisms and conditions leading to neuronal cell damage in the brain, focusing on severe hypoxia, ischemia, hypoglycemia, and status epilepticus. It highlights the vulnerability of brain cells, particularly neurons, due to their high energy demands and the inability to store oxygen and glucose. The text explores the cellular and metabolic changes associated with these conditions, including ionic shifts, metabolic perturbations, and mitochondrial dysfunction. It also examines the role of glial cells in modulating neuronal metabolic and ionic events. The severity and duration of insults causing neuronal damage are discussed, along with the revival times and histopathological alterations observed. The chapter concludes by exploring the mechanisms of ischemic cell damage, including the potential involvement of free radical formation and lipid peroxidation.The chapter discusses the mechanisms and conditions leading to neuronal cell damage in the brain, focusing on severe hypoxia, ischemia, hypoglycemia, and status epilepticus. It highlights the vulnerability of brain cells, particularly neurons, due to their high energy demands and the inability to store oxygen and glucose. The text explores the cellular and metabolic changes associated with these conditions, including ionic shifts, metabolic perturbations, and mitochondrial dysfunction. It also examines the role of glial cells in modulating neuronal metabolic and ionic events. The severity and duration of insults causing neuronal damage are discussed, along with the revival times and histopathological alterations observed. The chapter concludes by exploring the mechanisms of ischemic cell damage, including the potential involvement of free radical formation and lipid peroxidation.