title: New therapeutic approaches to subarachnoid hemorrhage.
abstract: BACKGROUND
  Subarachnoid hemorrhage (SAH) is associated with significant morbidity and mortality, even for patients who receive early neurointerventionist management.
  
  
  METHODS
  Early mechanisms of secondary brain injury precede the delayed vasospasm phase and contribute to the poor outcome. These mechanisms and their intervention are discussed, including high intracranial pressure (ICP), low cerebral perfusion pressure (CPP), acute vasospasm, disturbed cerebral autoregulation, cerebral edema, oxidative stress, seizures, microvascular damage and hyperglycemia. Erythropoietin, statins and magnesium have been particularly promising in experimental studies.
  
  
  CONCLUSIONS
  Multiple mechanisms, including delayed vasospasm, may contribute to cerebral ischemia and poor outcome following SAH. Treatments that simultaneously target multiple secondary injury pathways show significant potential as therapeutic agents, particularly those that attenuate vasospasm in addition to having other neuroprotective properties.
authors.affiliation: University of Adelaide, School of Medical Sciences, Adelaide Centre for Neuroscience Research, Adelaide, SA 5005, Australia.
authors.forename: Christine
authors.initials: C
authors.lastname: Barry
authors.forename: Renée J
authors.initials: RJ
authors.lastname: Turner
authors.forename: Frances
authors.initials: F
authors.lastname: Corrigan
authors.forename: Robert
authors.initials: R
authors.lastname: Vink
mesh_terms: D000818:Animals; D001930:Brain Injuries / Q000209:etiology / Q000517:prevention & control; D002545:Brain Ischemia / Q000503:physiopathology / Q000628:therapy*; D016503:Drug Delivery Systems; D006801:Humans; D019586:Intracranial Hypertension / Q000503:physiopathology / Q000628:therapy; D018696:Neuroprotective Agents / Q000627:therapeutic use; D018384:Oxidative Stress; D055502:Secondary Prevention / Q000379:methods; D013345:Subarachnoid Hemorrhage / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome; D020301:Vasospasm, Intracranial / Q000503:physiopathology / Q000628:therapy*
chemical_list: D018696:Neuroprotective Agents