title: Venous system in acute brain injury: Mechanisms of pathophysiological change and function.
abstract: Cerebral vascular injury is a major component of acute brain injury. Currently, neuroprotective strategies primarily focus on the recanalization of cerebral arteries and capillaries, and the protection of insulted neurons. Hitherto, the role of vein drainage in the pathophysiology of acute brain injury has been overlooked, due to an under appreciation of the magnitude of the impact of veins in circulation. In this review, we summarize the changes in the vein morphology and functions that are known, or likely to occur related to acute brain injury, and aim to advance the therapeutic management of acute brain injury by shifting the focus from reperfusion to another term: recirculation. Recent progress in the neurobiological understanding of the vascular neural network has demonstrated that cerebral venous systems are able to respond to acute brain injury by regulating the blood flow disharmony following brain edema, blood brain barrier disruption, ischemia, and hemorrhage. With the evidence presented in this review, future clinical management of acutely brain injured patients will expand to include the recirculation concept, establishing a harmony between arterial and venous systems, in addition to the established recanalization and reperfusion strategies.
authors.affiliation: Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
authors.forename: Sheng
authors.initials: S
authors.lastname: Chen
authors.affiliation: Department of Neurosurgery, Southwest Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Yujie
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Xu
authors.affiliation: Department of Physiology and Pharmacology, Loma Linda University, Loma Linda, California, USA.
authors.forename: Nathanael
authors.initials: N
authors.lastname: Matei
authors.affiliation: Department of Physiology and Pharmacology, Loma Linda University, Loma Linda, California, USA.
authors.forename: Jiping
authors.initials: J
authors.lastname: Tang
authors.affiliation: Department of Neurosurgery, Southwest Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Hua
authors.initials: H
authors.lastname: Feng
authors.affiliation: Department of Physiology and Pharmacology, Loma Linda University, Loma Linda, California, USA.
authors.forename: JohnH
authors.initials: J
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000818:Animals; D001929:Brain Edema / Q000209:etiology; D001930:Brain Injuries / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology*; D002319:Cardiovascular System / Q000503:physiopathology*; D002552:Cerebral Ventricles / Q000503:physiopathology; D002560:Cerebrovascular Circulation / Q000502:physiology*; D006801:Humans; D008297:Male; D011859:Radiography; D015898:Tomography Scanners, X-Ray Computed
keywords: Acute brain injury; Pathophysiology; Vascular neural network; Vein