Li Xiaopeng, Zeng Lang, Lu Xuanzhen, Chen Kun, Yu Maling, Wang Baofeng, Zhao Min
Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
Department of Neurology, The Third Hospital of Wuhan, Wuhan 430073, China.
Brain Sci. 2023 Jul 17;13(7):1083. doi: 10.3390/brainsci13071083.
Early brain injury (EBI) subsequent to subarachnoid hemorrhage (SAH) is strongly associated with delayed cerebral ischemia and poor patient prognosis. Based on investigations into the molecular mechanisms underlying EBI, neurovascular dysfunction resulting from SAH can be attributed to a range of pathological processes, such as microvascular alterations in brain tissue, ionic imbalances, blood-brain barrier disruption, immune-inflammatory responses, oxidative stress, and activation of cell death pathways. Research progress presents a variety of promising therapeutic approaches for the preservation of neurological function following SAH, including calcium channel antagonists, endothelin-1 receptor blockers, antiplatelet agents, anti-inflammatory agents, and anti-oxidative stress agents. EBI can be mitigated following SAH through neuroprotective measures. To enhance our comprehension of the relevant molecular pathways involved in brain injury, including brain ischemia-hypoxic injury, neuroimmune inflammation activation, and the activation of various cell-signaling pathways, following SAH, it is essential to investigate the evolution of these multifaceted pathophysiological processes. Facilitating neural repair following a brain injury is critical for improving patient survival rates and quality of life.
蛛网膜下腔出血(SAH)后的早期脑损伤(EBI)与迟发性脑缺血及患者预后不良密切相关。基于对EBI潜在分子机制的研究,SAH导致的神经血管功能障碍可归因于一系列病理过程,如脑组织微血管改变、离子失衡、血脑屏障破坏、免疫炎症反应、氧化应激以及细胞死亡途径的激活。研究进展提出了多种有望在SAH后保护神经功能的治疗方法,包括钙通道拮抗剂、内皮素-1受体阻滞剂、抗血小板药物、抗炎药物和抗氧化应激药物。通过神经保护措施可减轻SAH后的EBI。为了加深我们对SAH后脑损伤相关分子途径的理解,包括脑缺血缺氧损伤、神经免疫炎症激活以及各种细胞信号通路的激活,研究这些多方面病理生理过程的演变至关重要。促进脑损伤后的神经修复对于提高患者生存率和生活质量至关重要。