Metamorphosis of subarachnoid hemorrhage research: From delayed vasospasm to early brain injury

Fatima A. Sehba, Ryszard M. Pluta, John H. Zhang

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Delayed vasospasm that develops 3-7 days after aneurysmal subarachnoid hemorrhage (SAH) has traditionally been considered the most important determinant of delayed ischemic injury and poor outcome. Consequently, most therapies against delayed ischemic injury are directed towards reducing the incidence of vasospasm. The clinical trials based on this strategy, however, have so far claimed limited success; the incidence of vasospasm is reduced without reduction in delayed ischemic injury or improvement in the long-term outcome. This fact has shifted research interest to the early brain injury (first 72 h) evoked by SAH. In recent years, several pathological mechanisms that activate within minutes after the initial bleed and lead to early brain injury are identified. In addition, it is found that many of these mechanisms evolve with time and participate in the pathogenesis of delayed ischemic injury and poor outcome. Therefore, a therapy or therapies focused on these early mechanisms may not only prevent the early brain injury but may also help reduce the intensity of later developing neurological complications. This manuscript reviews the pathological mechanisms of early brain injury after SAH and summarizes the status of current therapies. © 2010 The Author(s).
    Original languageEnglish
    Pages (from-to)27-40
    Number of pages14
    JournalMolecular Neurobiology
    Volume43
    Issue number1
    DOIs
    StatePublished - Feb 2011

    ASJC Scopus Subject Areas

    • Neurology
    • Cellular and Molecular Neuroscience

    Keywords

    • Cerebral ischemia
    • Delayed vasospasm
    • Early brain injury
    • Subarachnoid hemorrhage
    • Therapeutic interventions
    • Humans
    • Stroke/etiology
    • Treatment Outcome
    • Cerebrovascular Circulation
    • Clinical Trials as Topic
    • Brain Injuries/etiology
    • Regional Blood Flow
    • Subarachnoid Hemorrhage/complications
    • Animals
    • Time Factors
    • Cell Death
    • Vasospasm, Intracranial/etiology

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