title: Early brain injury and subarachnoid hemorrhage: Where are we at present?
abstract: The current era has adopted many new innovations in nearly every aspect of management of subarachnoid hemorrhage (SAH); however, the neurological outcome has still not changed significantly. These major therapeutic advances mainly addressed the two most important sequels of the SAH-vasospasm and re-bleed. Thus, there is a possibility of some different pathophysiological mechanism that would be responsible for causing poor outcome in these patients. In this article, we have tried to compile the current role of this different yet potentially treatable pathophysiological mechanism in post-SAH patients. The main pathophysiological mechanism for the development of early brain injury (EBI) is the apoptotic pathways. The macro-mechanism includes increased intracranial pressure, disruption of the blood-brain barrier, and finally global ischemia. Most of the treatment strategies are still in the experimental phase. Although the role of EBI following SAH is now well established, the treatment modalities for human patients are yet to be testified.
authors: Department of Anesthesiology and Perioperative Medicine, Health Sciences Center, University of Manitoba, Winnipeg, Canada.
authors: Tumul
authors: T
authors: Chowdhury
authors: Hari Hara
authors: HH
authors: Dash
authors: Ronald B
authors: RB
authors: Cappellani
authors: Jayesh
authors: J
authors: Daya
keywords: Apoptosis; early brain injury; ischemia; subarachnoid hemorrhage
references: Cytokine. 2010 Dec;52(3):252-7
references: 20864352
references: Cochrane Database Syst Rev. 2004 Oct 18;(4):CD000483
references: 15494997
references: Neurol Res. 2009 Mar;31(2):114-21
references: 19298750
references: Curr Neurol Neurosci Rep. 2012 Feb;12(1):1-9
references: 21986684
references: J Pineal Res. 2012 Sep;53(2):129-37
references: 22304528
references: Curr Treat Options Neurol. 2012 Apr;14(2):164-74
references: 22249788
references: J Investig Med. 2012 Oct;60(7):1054-8
references: 22918199
references: Neurocrit Care. 2008;8(3):391-7
references: 18172784
references: Brain Res. 2012 Sep 7;1472:113-23
references: 22796593
references: J Neurosci Res. 2007 May 15;85(7):1436-48
references: 17410600
references: Crit Care Med. 2012 Jun;40(6):1908-13
references: 22488000
references: Neurosurgery. 2009 Aug;65(2):352-9; discussion 359
references: 19625915
references: Acta Neurochir Suppl. 2013;115:207-11
references: 22890670
references: J Neurotrauma. 2000 Mar;17(3):243-50
references: 10757329
references: BMC Neurosci. 2012 May 15;13:47
references: 22587664
references: Stroke. 2009 Jul;40(7):2519-25
references: 19461019
references: Stroke. 2011 Feb;42(2):477-83
references: 21193742
references: Acta Neurochir Suppl. 2011;112:101-6
references: 21691996
references: Acta Neurochir Suppl. 2011;110(Pt 1):43-8
references: 21116913
references: Acta Neurochir Suppl. 2011;110(Pt 1):57-61
references: 21116915
references: Acta Neurochir Suppl. 2011;110(Pt 1):105-9
references: 21116924
references: Acta Neurochir Suppl. 2006;96:188-93
references: 16671452
references: Rev Esp Anestesiol Reanim. 2010 Dec;57 Suppl 2:S4-15
references: 21298906
references: Neurosurg Clin N Am. 2010 Apr;21(2):235-46
references: 20380966
references: Lancet. 2002 Oct 26;360(9342):1267-74
references: 12414200
references: Cochrane Database Syst Rev. 2005 Oct 19;(4):CD003085
references: 16235314
references: J Cereb Blood Flow Metab. 2006 Nov;26(11):1341-53
references: 16482081
references: Lancet. 2005 Sep 3-9;366(9488):809-17
references: 16139655
references: Stroke. 2012 Sep;43(9):2513-6
references: 22773559
references: J Neurosci Res. 2011 Apr;89(4):515-23
references: 21259333
references: Neuroscience. 2012 Jun 28;213:144-53
references: 22521819
references: J Cereb Blood Flow Metab. 2010 Nov;30(11):1793-803
references: 20736956
references: Neurol Sci. 2010 Apr;31(2):143-9
references: 20033829
references: Acta Neurochir Suppl. 2011;110(Pt 1):75-9
references: 21116919
references: N Engl J Med. 2005 Jan 13;352(2):135-45
references: 15647576
references: Acta Neurochir Suppl. 2008;105:179-84
references: 19066106
references: Acta Neurochir Suppl. 2011;110(Pt 1):71-4
references: 21116918
references: Turk Neurosurg. 2010 Apr;20(2):159-66
references: 20401843