Controversies and evolving new mechanisms in subarachnoid hemorrhage.

Abstract:

:Despite decades of study, subarachnoid hemorrhage (SAH) continues to be a serious and significant health problem in the United States and worldwide. The mechanisms contributing to brain injury after SAH remain unclear. Traditionally, most in vivo research has heavily emphasized the basic mechanisms of SAH over the pathophysiological or morphological changes of delayed cerebral vasospasm after SAH. Unfortunately, the results of clinical trials based on this premise have mostly been disappointing, implicating some other pathophysiological factors, independent of vasospasm, as contributors to poor clinical outcomes. Delayed cerebral vasospasm is no longer the only culprit. In this review, we summarize recent data from both experimental and clinical studies of SAH and discuss the vast array of physiological dysfunctions following SAH that ultimately lead to cell death. Based on the progress in neurobiological understanding of SAH, the terms "early brain injury" and "delayed brain injury" are used according to the temporal progression of SAH-induced brain injury. Additionally, a new concept of the vasculo-neuronal-glia triad model for SAH study is highlighted and presents the challenges and opportunities of this model for future SAH applications.

journal_name

Prog Neurobiol

journal_title

Progress in neurobiology

authors

Chen S,Feng H,Sherchan P,Klebe D,Zhao G,Sun X,Zhang J,Tang J,Zhang JH

doi

10.1016/j.pneurobio.2013.09.002

subject

Has Abstract

pub_date

2014-04-01 00:00:00

pages

64-91

eissn

0301-0082

issn

1873-5118

pii

S0301-0082(13)00095-6

journal_volume

115

pub_type

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