Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Neurosurg Focus. 2013 May;34(5):E9. doi: 10.3171/2013.2.FOCUS1317.
Intracerebral hemorrhage (ICH) is associated with a higher degree of morbidity and mortality than other stroke subtypes. Despite this burden, currently approved treatments have demonstrated limited efficacy. To date, therapeutic strategies have principally targeted hematoma expansion and resultant mass effect. However, secondary mechanisms of brain injury are believed to be critical effectors of cell death and neurological outcome following ICH. This article reviews the pathophysiology of secondary brain injury relevant to ICH, examines pertinent experimental models, and highlights emerging therapeutic strategies. Treatment paradigms discussed include thrombin inhibitors, deferoxamine, minocycline, statins, granulocyte-colony stimulating factors, and therapeutic hypothermia. Despite promising experimental and preliminary human data, further studies are warranted prior to effective clinical translation.
脑出血 (ICH) 比其他类型的中风具有更高的发病率和死亡率。尽管负担沉重，但目前批准的治疗方法显示出疗效有限。迄今为止，治疗策略主要针对血肿扩大和由此产生的肿块效应。然而，继发性脑损伤机制被认为是脑出血后细胞死亡和神经功能结局的关键效应器。本文综述了与脑出血相关的继发性脑损伤的病理生理学，检查了相关的实验模型，并强调了新出现的治疗策略。讨论的治疗模式包括凝血酶抑制剂、去铁胺、米诺环素、他汀类药物、粒细胞集落刺激因子和治疗性低温。尽管有有希望的实验和初步人体数据，但在进行有效的临床转化之前，还需要进一步的研究。
