Details

Autor(en) / Beteiligte

• Ikram, Asad
• Javaid, Muhammad Ali
• Ortega-Gutierrez, Santiago
• Selim, Magdy
• Kelangi, Sarah
• Anwar, Syed Muhammad Hamza
• Torbey, Michel T.
• Divani, Afshin A.

Titel

Delayed Cerebral Ischemia after Subarachnoid Hemorrhage

Ist Teil von

• Journal of stroke and cerebrovascular diseases, 2021-11, Vol.30 (11), p.106064, Article 106064

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2021

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• Delayed cerebral ischemia (DCI) is the most feared complication of aneurysmal subarachnoid hemorrhage (aSAH). It increases the mortality and morbidity associated with aSAH. Previously, large cerebral artery vasospasm was thought to be the sole major contributing factor associated with increased risk of DCI. Recent literature has challenged this concept. We conducted a literature search using PUBMED as the prime source of articles discussing various other factors which may contribute to the development of DCI both in the presence or absence of large cerebral artery vasospasm. These factors include microvascular spasm, micro-thrombosis, cerebrovascular dysregulation, and cortical spreading depolarization. These factors collectively result in inflammation of brain parenchyma, which is thought to precipitate early brain injury and DCI. We conclude that diagnostic modalities need to be refined in order to diagnose DCI more efficiently in its early phase, and newer interventions need to be developed to prevent and treat this condition. These newer interventions are currently being studied in experimental models. However, their effectiveness on patients with aSAH is yet to be determined.