title: Cellular mechanisms of brain injury and cell death.
abstract: An array of clinical events may lead to perioperative neurological injury. We first review the general cellular mechanisms leading to brain tissue injury and death. The genesis and mechanisms of injury after cerebral aneurysm surgery, traumatic brain injury, postoperative vascular insult in patients with severe cerebrovascular disease are discussed, as are strategies for prevention and treatment. More has become known about the epidemiology, risk factors and potential preventive strategies in postoperative delirium, and, to a lesser extent, postoperative cognitive dysfunction. Finally, emerging concepts in clinical brain protection are discussed, including preconditioning, gene therapy and stem cells.
authors: Department of Anesthesiology, Ochsner Medical Center, New Orleans, Louisiana, USA. aschubert@ochsner.org
authors: Armin
authors: A
authors: Schubert
authors: Logan
authors: L
authors: Emory
mesh_terms: D000818:Animals; D001921:Brain / Q000473:pathology*; D001930:Brain Injuries / Q000209:etiology / Q000235:genetics / Q000401:mortality / Q000473:pathology* / Q000517:prevention & control / Q000523:psychology; D016923:Cell Death; D002561:Cerebrovascular Disorders / Q000209:etiology / Q000235:genetics / Q000401:mortality / Q000473:pathology* / Q000517:prevention & control / Q000523:psychology; D003072:Cognition Disorders / Q000209:etiology / Q000473:pathology / Q000523:psychology; D003693:Delirium / Q000209:etiology / Q000473:pathology / Q000523:psychology; D015316:Genetic Therapy; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000209:etiology / Q000473:pathology; D018696:Neuroprotective Agents / Q000627:therapeutic use; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D059035:Perioperative Period; D011183:Postoperative Complications / Q000235:genetics / Q000401:mortality / Q000473:pathology* / Q000517:prevention & control; D033581:Stem Cell Transplantation
chemical_list: D018696:Neuroprotective Agents