Department of Neurology, Center for Stroke Research Berlin, Charité - University Medicine Berlin, Charitéplatz 1, 10117 Berlin, Germany.
Best Pract Res Clin Anaesthesiol. 2010 Dec;24(4):495-509. doi: 10.1016/j.bpa.2010.10.001. Epub 2010 Nov 29.
Ischaemic stroke and brain trauma are among the leading causes of mortality and long-term disability in the western world. Enormous endeavours have been made to elucidate the complex pathophysiology of ischaemic and traumatic brain injury with the intention of developing new therapeutic strategies for patients suffering from these devastating diseases. This article reviews the current knowledge on cascades that are activated after ischaemic and traumatic brain injury and that lead to progression of tissue damage. Main attention will be on pathophysiological events initiated after ischaemic stroke including excitotoxicity, oxidative/nitrosative stress, peri-infarct depolarizations, apoptosis and inflammation. Additionally, specific pathophysiological aspects after traumatic brain injury will be discussed along with their similarities and differences to ischaemic brain injury. This article provides prerequisites for understanding the therapeutic strategies for stroke and trauma patients which are addressed in other articles of this issue.
缺血性中风和脑外伤是西方世界导致死亡和长期残疾的主要原因之一。人们已经做出了巨大的努力来阐明缺血性和外伤性脑损伤的复杂病理生理学,以期为这些毁灭性疾病的患者开发新的治疗策略。本文综述了缺血性和外伤性脑损伤后激活的级联反应及其导致组织损伤进展的最新知识。主要关注的是缺血性中风后引发的病理生理事件,包括兴奋性毒性、氧化/硝化应激、梗死周围去极化、细胞凋亡和炎症。此外,还将讨论外伤性脑损伤后的特定病理生理方面,并讨论其与缺血性脑损伤的相似和不同之处。本文为理解本期其他文章中讨论的中风和创伤患者的治疗策略提供了前提条件。