Oka Fumiaki, Ishihara Hideyuki
Department of Neurosurgery, Yamaguchi University School of Medicine.
No Shinkei Geka. 2024 Sep;52(5):899-905. doi: 10.11477/mf.1436204997.
Aneurysmal subarachnoid hemorrhage(aSAH) is a critical condition that often results in severe neurological deficits. Recent studies have highlighted the role of spreading depolarization(SD) in post-aSAH secondary brain injury. SD comprises rapid and sequential changes in neuronal and glial membrane potentials that disrupt energy metabolism and induce neuronal dysfunction. Implicated in both early brain injury(EBI) and delayed cerebral ischemia(DCI), SD worsens clinical outcomes. This review explores the SD-associated mechanisms in aSAH, ascertains the contribution of SD to EBI and DCI, and identifies potential SD-targeted therapeutic strategies to improve the prognosis of aSAH.
动脉瘤性蛛网膜下腔出血(aSAH)是一种危急病症,常导致严重的神经功能缺损。最近的研究强调了去极化扩散(SD)在aSAH后脑继发性损伤中的作用。SD包括神经元和胶质细胞膜电位的快速和连续变化,这些变化会破坏能量代谢并诱导神经元功能障碍。SD与早期脑损伤(EBI)和延迟性脑缺血(DCI)均有关联,会使临床预后恶化。本综述探讨了aSAH中与SD相关的机制,确定了SD对EBI和DCI的影响,并确定了潜在的以SD为靶点的治疗策略,以改善aSAH的预后。