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Similarities in the Electrographic Patterns of Delayed Cerebral Infarction and Brain Death After Aneurysmal and Traumatic Subarachnoid Hemorrhage.

作者信息

Dreier Jens P, Lemale Coline L, Horst Viktor, Major Sebastian, Kola Vasilis, Schoknecht Karl, Scheel Michael, Hartings Jed A, Vajkoczy Peter, Wolf Stefan, Woitzik Johannes, Hecht Nils

机构信息

Center for Stroke Research Berlin, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany.

Department of Experimental Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.

出版信息

Transl Stroke Res. 2025 Feb;16(1):147-168. doi: 10.1007/s12975-024-01237-w. Epub 2024 Feb 23.


DOI:10.1007/s12975-024-01237-w
PMID:38396252
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11772537/
Abstract

While subarachnoid hemorrhage is the second most common hemorrhagic stroke in epidemiologic studies, the recent DISCHARGE-1 trial has shown that in reality, three-quarters of focal brain damage after subarachnoid hemorrhage is ischemic. Two-fifths of these ischemic infarctions occur early and three-fifths are delayed. The vast majority are cortical infarcts whose pathomorphology corresponds to anemic infarcts. Therefore, we propose in this review that subarachnoid hemorrhage as an ischemic-hemorrhagic stroke is rather a third, separate entity in addition to purely ischemic or hemorrhagic strokes. Cumulative focal brain damage, determined by neuroimaging after the first 2 weeks, is the strongest known predictor of patient outcome half a year after the initial hemorrhage. Because of the unique ability to implant neuromonitoring probes at the brain surface before stroke onset and to perform longitudinal MRI scans before and after stroke, delayed cerebral ischemia is currently the stroke variant in humans whose pathophysiological details are by far the best characterized. Optoelectrodes located directly over newly developing delayed infarcts have shown that, as mechanistic correlates of infarct development, spreading depolarizations trigger (1) spreading ischemia, (2) severe hypoxia, (3) persistent activity depression, and (4) transition from clustered spreading depolarizations to a negative ultraslow potential. Furthermore, traumatic brain injury and subarachnoid hemorrhage are the second and third most common etiologies of brain death during continued systemic circulation. Here, we use examples to illustrate that although the pathophysiological cascades associated with brain death are global, they closely resemble the local cascades associated with the development of delayed cerebral infarcts.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f9b/11772537/84f38025b5ce/12975_2024_1237_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f9b/11772537/21dfaf7048e9/12975_2024_1237_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f9b/11772537/39ea1498b587/12975_2024_1237_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f9b/11772537/d0af8dcd6ee1/12975_2024_1237_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f9b/11772537/8b00f3876e84/12975_2024_1237_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f9b/11772537/edc05c50cad5/12975_2024_1237_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f9b/11772537/2729a49d1713/12975_2024_1237_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f9b/11772537/84f38025b5ce/12975_2024_1237_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f9b/11772537/21dfaf7048e9/12975_2024_1237_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f9b/11772537/39ea1498b587/12975_2024_1237_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f9b/11772537/d0af8dcd6ee1/12975_2024_1237_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f9b/11772537/8b00f3876e84/12975_2024_1237_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f9b/11772537/edc05c50cad5/12975_2024_1237_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f9b/11772537/2729a49d1713/12975_2024_1237_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f9b/11772537/84f38025b5ce/12975_2024_1237_Fig7_HTML.jpg

相似文献

[1]
Similarities in the Electrographic Patterns of Delayed Cerebral Infarction and Brain Death After Aneurysmal and Traumatic Subarachnoid Hemorrhage.

Transl Stroke Res. 2025-2

[2]
All Three Supersystems-Nervous, Vascular, and Immune-Contribute to the Cortical Infarcts After Subarachnoid Hemorrhage.

Transl Stroke Res. 2025-2

[3]
Subarachnoid blood acutely induces spreading depolarizations and early cortical infarction.

Brain. 2017-10-1

[4]
A case report of delayed cortical infarction adjacent to sulcal clots after traumatic subarachnoid hemorrhage in the absence of proximal vasospasm.

BMC Neurol. 2018-12-18

[5]
Correlates of spreading depolarization in human scalp electroencephalography.

Brain. 2012-3

[6]
Requisite ischemia for spreading depolarization occurrence after subarachnoid hemorrhage in rodents.

J Cereb Blood Flow Metab. 2017-5

[7]
Spreading depolarizations in ischaemia after subarachnoid haemorrhage, a diagnostic phase III study.

Brain. 2022-5-24

[8]
Oxygen availability and spreading depolarizations provide complementary prognostic information in neuromonitoring of aneurysmal subarachnoid hemorrhage patients.

J Cereb Blood Flow Metab. 2017-5

[9]
Simulation of spreading depolarization trajectories in cerebral cortex: Correlation of velocity and susceptibility in patients with aneurysmal subarachnoid hemorrhage.

Neuroimage Clin. 2017-9-6

[10]
Dissociation of Early and Delayed Cerebral Infarction After Aneurysmal Subarachnoid Hemorrhage.

Stroke. 2016-12

引用本文的文献

[1]
Acute-Phase Recording of the Spreading Depolarization Continuum in Aged Nonhuman Primates During Focal Ischemic Stroke.

Stroke. 2025-4

[2]
Reduced brain oxygen response to spreading depolarization predicts worse outcome in ischaemic stroke.

Brain. 2025-6-3

[3]
Oxygen-Based Autoregulation Indices Associated with Clinical Outcomes and Spreading Depolarization in Aneurysmal Subarachnoid Hemorrhage.

Neurocrit Care. 2025-4

[4]
Ketamine-induced prevention of SD-associated late infarct progression in experimental ischemia.

Sci Rep. 2024-5-3

本文引用的文献

[1]
Memantine inhibits cortical spreading depolarization and improves neurovascular function following repetitive traumatic brain injury.

Sci Adv. 2023-12-15

[2]
Diversity of cortical activity changes beyond depression during Spreading Depolarizations.

Nat Commun. 2023-11-25

[3]
Effectiveness of Lumbar Cerebrospinal Fluid Drain Among Patients With Aneurysmal Subarachnoid Hemorrhage: A Randomized Clinical Trial.

JAMA Neurol. 2023-8-1

[4]
Improving Neurotrauma by Depolarization Inhibition With Combination Therapy: A Phase 2 Randomized Feasibility Trial.

Neurosurgery. 2023-10-1

[5]
Spreading depolarization and angiographic spasm are separate mediators of delayed infarcts.

Brain Commun. 2023-3-22

[6]
Optogenetic Spreading Depolarizations Do Not Worsen Acute Ischemic Stroke Outcome.

Stroke. 2023-4

[7]
Less-invasive subdural electrocorticography for investigation of spreading depolarizations in patients with subarachnoid hemorrhage.

Front Neurol. 2023-1-5

[8]
Computed Tomography Lesions and Their Association With Global Outcome in Young People With Mild Traumatic Brain Injury.

J Neurotrauma. 2023-6

[9]
Stroke-prone salt-sensitive spontaneously hypertensive rats show higher susceptibility to spreading depolarization (SD) and altered hemodynamic responses to SD.

J Cereb Blood Flow Metab. 2023-2

[10]
Invasive Diagnostic and Therapeutic Management of Cerebral VasoSpasm after Aneurysmal Subarachnoid Hemorrhage (IMCVS)-A Phase 2 Randomized Controlled Trial.

J Clin Med. 2022-10-20

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