Hematoma removal, heme, and heme oxygenase following hemorrhagic stroke.
The hemorrhagic strokes, intracerebral (ICH) and subarachnoid hemorrhage (SAH), often have poor outcomes. Indeed, the most common hemorrhagic stroke, ICH, has the highest mortality and morbidity rates of any stroke subtype. In this report, we discuss the evidence for the staging of red blood cell removal after ICH and the significance of control of this process. The protective effects of clinically relevant metalloporphyrin heme oxygenase inhibitors in experimental models of ICH and in superficial siderosis are also discussed. We also examine literature paradoxes related to both heme and heme oxygenase in various disorders of the central nervous system. Last, new data are presented that support the concept that heme, although primarily a pro-oxidant, can also have antioxidant properties.
Wagner
Kenneth R
KR
Medical Research Service, Department of Veterans Affairs Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio 45220, USA. wagnerkr@email.uc.edu
Dwyer
Barney E
BE
D000818:Animals; D002545:Brain Ischemia / Q000150:complications*; D004305:Dose-Response Relationship, Drug; D006406:Hematoma / Q000601:surgery*; D006418:Heme / Q000378:metabolism* / Q000627:therapeutic use; D006419:Heme Oxygenase (Decyclizing) / Q000378:metabolism*; D006454:Hemoglobins; D006801:Humans; D020300:Intracranial Hemorrhages / Q000201:enzymology / Q000209:etiology* / Q000378:metabolism / Q000517:prevention & control; D008665:Metalloporphyrins / Q000627:therapeutic use; D020521:Stroke / Q000097:blood / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D013997:Time Factors
D006454:Hemoglobins; D008665:Metalloporphyrins; D006418:Heme; D006419:Heme Oxygenase (Decyclizing)