Department of Neurology (S.N.O., J.H.D., L.H.S.), Yale School of Medicine, New Haven, CT.
Department of Immunobiology (S.N.O., J.H.D., L.H.S.), Yale School of Medicine, New Haven, CT.
Stroke. 2023 Feb;54(2):605-619. doi: 10.1161/STROKEAHA.122.037155. Epub 2023 Jan 5.
Hemorrhagic stroke is the deadliest form of stroke and includes the subtypes of intracerebral hemorrhage and subarachnoid hemorrhage. A common cause of hemorrhagic stroke in older individuals is cerebral amyloid angiopathy. Intracerebral hemorrhage and subarachnoid hemorrhage both lead to the rapid collection of blood in the central nervous system and generate inflammatory immune responses that involve both brain resident and infiltrating immune cells. These responses are complex and can contribute to both tissue recovery and tissue injury. Despite the interconnectedness of these major subtypes of hemorrhagic stroke, few reviews have discussed them collectively. The present review provides an update on inflammatory processes that occur in response to intracerebral hemorrhage and subarachnoid hemorrhage, and the role of inflammation in the pathophysiology of cerebral amyloid angiopathy-related hemorrhage. The goal is to highlight inflammatory processes that underlie disease pathology and recovery. We aim to discuss recent advances in our understanding of these conditions and identify gaps in knowledge with the potential to develop effective therapeutic strategies.
出血性中风是中风中最致命的一种类型,包括脑内出血和蛛网膜下腔出血两种亚型。老年人出血性中风的一个常见病因是脑淀粉样血管病。脑内出血和蛛网膜下腔出血都会导致血液在中枢神经系统内迅速积聚,并引发炎症免疫反应,涉及脑内固有和浸润性免疫细胞。这些反应十分复杂,既可以促进组织恢复,也会导致组织损伤。尽管这些主要的出血性中风亚型相互关联,但很少有综述对其进行综合讨论。本综述介绍了针对脑内出血和蛛网膜下腔出血而发生的炎症过程,以及炎症在脑淀粉样血管病相关出血的病理生理学中的作用。其目的是突出与疾病病理和恢复相关的炎症过程。我们旨在讨论对这些病症的理解方面的最新进展,并确定具有开发有效治疗策略潜力的知识空白。