Faculty of Life Sciences, The University of Manchester, Manchester, UK.
J Cereb Blood Flow Metab. 2011 Nov;31(11):2135-51. doi: 10.1038/jcbfm.2011.124. Epub 2011 Aug 24.
Intracerebral hemorrhage (ICH) has the highest mortality of all stroke subtypes, yet treatments are mainly limited to supportive management, and surgery remains controversial. Despite significant advances in our understanding of ICH pathophysiology, we still lack preclinical models that accurately replicate the underlying mechanisms of injury. Current experimental ICH models (including autologous blood and collagenase injection) simulate different aspects of ICH-mediated injury but lack some features of the clinical condition. Newly developed models, notably hypertension- and oral anticoagulant therapy-associated ICH models, offer added benefits but further study is needed to fully validate them. Here, we describe and discuss current approaches to experimental ICH, with suggestions for changes in how this condition is studied in the laboratory. Although advances in imaging over the past few decades have allowed greater insight into clinical ICH, there remains an important role for experimental models in furthering our understanding of the basic pathophysiologic processes underlying ICH, provided limitations of animal models are borne in mind. Owing to differences in existing models and the failed translation of benefits in experimental ICH to clinical practice, putative neuroprotectants should be trialed in multiple models using both histological and functional outcomes until a more accurate model of ICH is developed.
脑出血（ICH）是所有脑卒中亚型中死亡率最高的，然而治疗方法主要限于支持性治疗，手术仍然存在争议。尽管我们对 ICH 病理生理学的理解有了显著的进展，但我们仍然缺乏能够准确复制损伤潜在机制的临床前模型。目前的实验性 ICH 模型（包括自体血和胶原酶注射）模拟了 ICH 介导损伤的不同方面，但缺乏一些临床情况的特征。新开发的模型，特别是与高血压和口服抗凝治疗相关的 ICH 模型，提供了额外的益处，但需要进一步研究来充分验证它们。在这里，我们描述和讨论了目前实验性 ICH 的方法，并就如何在实验室中研究这种情况提出了一些建议。尽管过去几十年成像技术的进步使我们对临床 ICH 有了更深入的了解，但实验模型在进一步了解 ICH 潜在的基本病理生理过程方面仍然具有重要作用，只要记住动物模型的局限性。由于现有模型的差异以及实验性 ICH 中获益未能转化为临床实践，神经保护剂应该在多个模型中使用组织学和功能结果进行试验，直到开发出更准确的 ICH 模型。
