医学
脑脊液
神经学
神经外科
脑积水
蛛网膜下腔出血
蛛网膜下腔出血
缺血性中风
神经组阅片室
麻醉
病理
重症监护医学
缺血
外科
心脏病学
动脉瘤
精神科
作者
Soham Bandyopadhyay,Nina Schwendinger,Behnam Rezai Jahromi,Shivanand P. Lad,Spiros Blackburn,Stefan Wolf,Diederik Bulters,Ian Galea,Michael Hugelshofer
标识
DOI:10.1007/s12975-024-01238-9
摘要
Subarachnoid haemorrhage (SAH) is a subtype of stroke that predominantly impacts younger individuals. It is associated with high mortality rates and can cause long-term disabilities. This review examines the contribution of the initial blood load and the dynamics of clot clearance to the pathophysiology of SAH and the risk of adverse outcomes. These outcomes include hydrocephalus and delayed cerebral ischaemia (DCI), with a particular focus on the impact of blood located in the cisternal spaces, as opposed to ventricular blood, in the development of DCI. The literature described underscores the prognostic value of haematoma characteristics, such as volume, density, and anatomical location. The limitations of traditional radiographic grading systems are discussed, compared with the more accurate volumetric quantification techniques for predicting patient prognosis. Further, the significance of red blood cells (RBCs) and their breakdown products in secondary brain injury after SAH is explored. The review presents novel interventions designed to accelerate clot clearance or mitigate the effects of toxic byproducts released from erythrolysis in the cerebrospinal fluid following SAH. In conclusion, this review offers deeper insights into the complex dynamics of SAH and discusses the potential pathways available for advancing its management.
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