Johns Hopkins School of Medicine, 600 North Wolfe Street, Meyer 8-140, Baltimore, MD 21287-7840, USA.
Neurosurg Clin N Am. 2010 Apr;21(2):381-91. doi: 10.1016/j.nec.2009.10.009.
Subarachnoid hemorrhage from the rupture of a saccular aneurysm is a devastating neurological disease that has a high morbidity and mortality not only from the initial hemorrhage, but also from the delayed complications, such as cerebral vasospasm. Cerebral vasospasm can lead to delayed ischemic injury 1 to 2 weeks after the initial hemorrhage. Although the pathophysiology of vasospasm has been described for decades, the molecular basis remains poorly understood. With the many advances in the past decade in the development of sensitive molecular biological techniques, imaging, biochemical purification, and protein identification, new insights are beginning to reveal the etiology of vasospasm. These findings will not only help to identify markers of vasospasm and prognostic outcome, but will also yield potential therapeutic targets for the treatment of this disease. This review focuses on the methods available for the identification of biological markers of vasospasm and their limitations, the current understanding as to the utility and prognostic significance of identified biomarkers, the utility of these biomarkers in predicting vasospasm and outcome, and future directions of research in this field.
蛛网膜下腔出血是由囊状动脉瘤破裂引起的，是一种毁灭性的神经系统疾病，其发病率和死亡率不仅与初始出血有关，还与迟发性并发症如脑血管痉挛有关。脑血管痉挛可导致初始出血后 1 至 2 周发生迟发性缺血性损伤。尽管几十年来已经描述了血管痉挛的病理生理学，但分子基础仍知之甚少。过去十年中，随着敏感的分子生物学技术、成像、生化纯化和蛋白质鉴定的许多进展，新的见解开始揭示血管痉挛的病因。这些发现不仅有助于确定血管痉挛和预后结果的标志物，而且还将为治疗这种疾病提供潜在的治疗靶点。这篇综述重点介绍了鉴定血管痉挛生物标志物的方法及其局限性、已鉴定生物标志物的实用性和预后意义、这些生物标志物在预测血管痉挛和结果方面的用途，以及该领域未来的研究方向。
