Stroke Research Group, UCL Institute of Neurology and The National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK.
Expert Rev Neurother. 2014 Jun;14(6):661-78. doi: 10.1586/14737175.2014.918506.
Spontaneous (non-traumatic) symptomatic intracerebral hemorrhage is a devastating form of stroke, with very high overall mortality and morbidity. Even with the best current medical or surgical treatment, outcomes still remain poor. By contrast with ischemic stroke, the incidence of intracerebral hemorrhage is not decreasing. Indeed, the incidence of intracerebral hemorrhage related to antithrombotic drugs, including oral anticoagulants, has increased in recent decades. Despite the clear unmet research need for both prevention and acute treatment, there has, until recently, been limited progress in understanding the pathogenesis of this disease. New advances, especially related to neuroimaging biomarkers, are rapidly increasing our understanding of the spectrum of mechanisms of brain injury in intracerebral hemorrhage. The aim of this article is to review recent insights from neuroimaging studies into the pathophysiology and causes of intracerebral hemorrhage, focusing on MRI. We also discuss some of the current and future challenges facing clinicians in understanding and treating intracerebral hemorrhage.
自发性（非外伤性）症状性脑出血是一种毁灭性的中风形式，总体死亡率和发病率非常高。即使采用目前最好的药物或手术治疗，预后仍然不佳。与缺血性中风不同，脑出血的发病率并没有下降。事实上，与抗血栓药物（包括口服抗凝剂）相关的脑出血发病率在最近几十年有所增加。尽管预防和急性治疗都有明确的未满足的研究需求，但直到最近，人们对这种疾病的发病机制的理解才取得了有限的进展。新的进展，特别是与神经影像学生物标志物相关的进展，正在迅速加深我们对脑出血中脑损伤机制的认识。本文的目的是综述神经影像学研究对脑出血病理生理学和病因的最新认识，重点是 MRI。我们还讨论了目前和未来临床医生在理解和治疗脑出血方面面临的一些挑战。
