Department of Anesthesiology, Ochsner Medical Center, New Orleans, Louisiana, USA.
Curr Pharm Des. 2012;18(38):6325-30. doi: 10.2174/138161212803832425.
An array of clinical events may lead to perioperative neurological injury. We first review the general cellular mechanisms leading to brain tissue injury and death. The genesis and mechanisms of injury after cerebral aneurysm surgery, traumatic brain injury, postoperative vascular insult in patients with severe cerebrovascular disease are discussed, as are strategies for prevention and treatment. More has become known about the epidemiology, risk factors and potential preventive strategies in postoperative delirium, and, to a lesser extent, postoperative cognitive dysfunction. Finally, emerging concepts in clinical brain protection are discussed, including preconditioning, gene therapy and stem cells.
一系列临床事件可能导致围手术期神经系统损伤。我们首先回顾导致脑组织损伤和死亡的一般细胞机制。讨论了脑动脉瘤手术、创伤性脑损伤、严重脑血管病患者术后血管损伤后的发病机制和损伤机制，以及预防和治疗策略。术后谵妄的流行病学、危险因素和潜在预防策略有了更多的了解，而术后认知功能障碍则了解较少。最后，讨论了临床脑保护中的一些新观点，包括预处理、基因治疗和干细胞。
