Zheng Haiping, Chen Chunli, Zhang Jie, Hu Zhiping
Department of Neurology, The Second Xiangya Hospital of Central South University, Changsha, China.
Cerebrovasc Dis. 2016;42(3-4):155-69. doi: 10.1159/000445170. Epub 2016 Apr 26.
Intracerebral hemorrhage (ICH) is a subtype of stroke with a severe high mortality and disability rate and accounts for about 10-15% of all strokes. The oppression and destruction by hematoma to brain tissue cause the primary brain injury. The inflammation and coagulation response after ICH would accelerate the formation of brain edema around hematoma, resulting in a more severe and durable injury. Currently, treatments for ICH are focusing on the primary injury including reducing intracranial hypertension, blood pressure control, and rehabilitation. There is a short-of-effective medical treatment for secondary inflammation and reducing brain edema in ICH patients. So, it is very important to study on the relationship between brain edema and ICH.
Many molecular and cellular mechanisms contribute to the formation and progress of brain edema after ICH; inhibition of brain edema provides favorable outcome of ICH.
This review mainly discusses the pathology and mechanism of brain edema, the effects of brain edema on ICH, and the methods of treating brain edema after ICH.
脑出血(ICH)是中风的一种亚型,具有极高的死亡率和致残率,约占所有中风的10%-15%。血肿对脑组织的压迫和破坏会导致原发性脑损伤。脑出血后的炎症和凝血反应会加速血肿周围脑水肿的形成,导致更严重、更持久的损伤。目前,脑出血的治疗主要集中在原发性损伤,包括降低颅内压、控制血压和康复治疗。对于脑出血患者继发性炎症和减轻脑水肿,缺乏有效的药物治疗。因此,研究脑水肿与脑出血之间的关系非常重要。
许多分子和细胞机制参与了脑出血后脑水肿的形成和进展;抑制脑水肿可改善脑出血的预后。
本综述主要讨论了脑水肿的病理和机制、脑水肿对脑出血的影响以及脑出血后脑水肿的治疗方法。