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Pre-Chiasmatic, Single Injection of Autologous Blood to Induce Experimental Subarachnoid Hemorrhage in a Rat Model
Published on: June 18, 2021
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Delayed neurological deterioration after subarachnoid haemorrhage
1Division of Neurosurgery, St Michael's Hospital, 30 Bond Street, Toronto, ON M5B 1W8, Canada.
Nature Reviews. Neurology
|December 11, 2013
Summary
Subarachnoid haemorrhage (SAH) can lead to delayed cerebral ischaemia (DCI), a major cause of poor outcomes. This review explores DCI pathophysiology and treatments, including novel strategies.
Area of Science:
- Neurology
- Neurosurgery
- Critical Care Medicine
Background:
- Subarachnoid haemorrhage (SAH) causes early brain injury (EBI) and secondary complications.
- Delayed cerebral ischaemia (DCI) significantly contributes to poor outcomes in up to 30% of SAH patients.
- DCI pathophysiology involves vasospasm, thrombosis, and processes triggered by EBI.
Purpose of the Study:
- To review the pathophysiology of DCI following SAH.
- To discuss established and novel treatment strategies for DCI.
- To highlight the importance of prompt DCI recognition and management.
Main Methods:
- Literature review of SAH and DCI pathophysiology.
- Summary of current neurointensive care and DCI treatments.
- Discussion of emerging therapeutic agents and delivery methods.
Main Results:
- SAH-induced EBI and subarachnoid blood contribute to secondary brain injury.
- DCI is a complex process involving multiple ischemic and inflammatory pathways.
- Established treatments include nimodipine and supportive neurocritical care; evidence for induced hypertension and angioplasty is limited.
Conclusions:
- Understanding DCI pathophysiology is crucial for effective management.
- Novel therapeutic strategies show promise for improving DCI outcomes.
- Further research is needed to validate new treatments for DCI after SAH.
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