New insights into the causes and therapy of cerebral vasospasm following subarachnoid hemorrhage.
Cerebral vasospasm lingers as the leading preventable cause of death and disability in patients who experience aneurysmal subarachnoid hemorrhage. Despite the potentially devastating consequences of cerebral vasospasm, the mechanisms behind it are incompletely understood. Nitric oxide, endothelin-1, bilirubin oxidation products and inflammation appear to figure prominently in its pathogenesis. Therapies directed at many of these mechanisms are currently under investigation and hold significant promise for an ultimate solution to this substantial problem.
Crowley
R Webster
RW
Department of Neurological Surgery, University of Virginia, School of Medicine, Charlottesville, VA, United States. rc9dd@virginia.edu
Medel
Ricky
R
Kassell
Neal F
NF
Dumont
Aaron S
AS
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001663:Bilirubin / Q000378:metabolism; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D002533:Cerebral Angiography; D004660:Encephalitis / Q000378:metabolism / Q000517:prevention & control; D019332:Endothelin-1 / Q000378:metabolism; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006419:Heme Oxygenase (Decyclizing) / Q000378:metabolism; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D002532:Intracranial Aneurysm / Q000150:complications; D008274:Magnesium / Q000627:therapeutic use; D009119:Muscle Contraction; D009131:Muscle, Smooth, Vascular / Q000503:physiopathology; D009569:Nitric Oxide / Q000378:metabolism; D013345:Subarachnoid Hemorrhage / Q000150:complications*; D013997:Time Factors; D020301:Vasospasm, Intracranial / Q000209:etiology / Q000378:metabolism / Q000628:therapy*
D000893:Anti-Inflammatory Agents; D002121:Calcium Channel Blockers; D019332:Endothelin-1; D005343:Fibrinolytic Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D009569:Nitric Oxide; D006419:Heme Oxygenase (Decyclizing); D008274:Magnesium; D001663:Bilirubin