Fu Xiongjie, Zhou Guoyang, Zhuang Jianfeng, Xu Chaoran, Zhou Hang, Peng Yucong, Cao Yang, Zeng Hanhai, Li Jianru, Yan Feng, Wang Lin, Chen Gao
Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Front Neurol. 2021 Jun 10;12:562090. doi: 10.3389/fneur.2021.562090. eCollection 2021.
Spontaneous intracerebral hemorrhage (ICH) accounts for 15% of all stroke cases. ICH is a devastating form of stroke associated with high morbidity, mortality, and disability. Preclinical studies have explored the mechanisms of neuronal death and gray matter damage after ICH. However, few studies have examined the development of white matter injury (WMI) following ICH. Research on WMI indicates that its pathophysiological presentation involves axonal damage, demyelination, and mature oligodendrocyte loss. However, the detailed relationship and mechanism between WMI and ICH remain unclear. Studies of other acute brain insults have indicated that WMI is strongly correlated with cognitive deficits, neurological deficits, and depression. The degree of WMI determines the short- and long-term prognosis of patients with ICH. This review demonstrates the structure and functions of the white matter in the healthy brain and discusses the pathophysiological mechanism of WMI following ICH. Our review reveals that the development of WMI after ICH is complex; therefore, comprehensive treatment is essential. Understanding the relationship between WMI and other brain cells may reveal therapeutic targets for the treatment of ICH.
自发性脑出血（ICH）占所有中风病例的15%。ICH是一种破坏性的中风形式，与高发病率、死亡率和残疾率相关。临床前研究已经探讨了ICH后神经元死亡和灰质损伤的机制。然而，很少有研究考察ICH后白质损伤（WMI）的发展情况。关于WMI的研究表明，其病理生理表现涉及轴突损伤、脱髓鞘和成熟少突胶质细胞丢失。然而，WMI与ICH之间的详细关系和机制仍不清楚。对其他急性脑损伤的研究表明，WMI与认知缺陷、神经功能缺损和抑郁密切相关。WMI的程度决定了ICH患者的短期和长期预后。本综述阐述了健康大脑中白质的结构和功能，并讨论了ICH后WMI的病理生理机制。我们的综述表明，ICH后WMI的发展是复杂的；因此，综合治疗至关重要。了解WMI与其他脑细胞之间的关系可能会揭示ICH治疗的靶点。
