Neuroinflammation As A Target For Intervention In Subarachnoid Hemorrhage
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Author | : Fernando Testai |
Publisher | : Frontiers Media SA |
Total Pages | : 88 |
Release | : 2020-01-10 |
Genre | : |
ISBN | : 2889633039 |
Aneurysmal subarachnoid hemorrhage (SAH) is a stroke subtype that affects, preponderantly, young adults. This condition carries a mortality of approximately 30-50% and a rate of permanent neurological disability of 30%. In addition, a substantial number of patients with an apparent good outcome suffer from residual neurocognitive impairment which, though subtle, prevents them from returning to work and having a normal life. Based on these data, it has been estimated that SAH is responsible for almost a quarter of all the years lost because of stroke. The calcium channel blocker nimodipine remains the only pharmacological treatment for SAH. This drug, however, has limited effectiveness and its use in clinical practice may be limited due to hypotension. Therefore, novel and effective treatments for this condition are desperately needed. The outcome in SAH has been associated with early brain injury, vasospasm, and delayed cerebral ischemia. Mechanistically, these processes are characterized by micro- and macro-vascular dysfunction, microthrombi formation, blood-brain barrier (BBB) dysregulation, brain edema, and neural-cell survival. Soon after SAH, there is a robust inflammatory response characterized by pyrexia, leukocytosis, and upregulation of adhesion molecules and cytokines in the periphery and in the CNS. Observational studies have shown that patients with more severe inflammatory responses experience worse outcomes after SAH. At the molecular level, different proinflammatory intracellular signaling pathways, including mitogen-activated protein-kinase and nuclear factor kappa-β, are activated in cerebral vessels after experimental SAH and their inhibition has been shown to decrease the occurrence of vasospasm. In addition, clinical and preclinical data have linked cytokine upregulation (interleukins [IL]-1B, IL-6 and IL-8, tumor necrosis factor-α, and monocyte chemoattractant protein-1), enhanced expression of adhesion molecules (selectins, integrins, and ICAM), and neutrophil activation to vasospasm of large cerebral arteries, microvascular dysregulation, and cell death. Moreover, immune cells regulate hemostasis and secrete active proteases, including matrix metalloproteinase 9, which promote microthrombosis and induce blood brain barrier dysfunction, respectively. In this context, it has been suggested that an enhanced inflammatory burden might contribute to brain injury in SAH through numerous downstream mechanisms. On the other hand, growing evidence demonstrates that neuroinflammation may influence the proliferation and migration of progenitor cells that participate of synaptic plasticity, neurogenesis, and neurorepair.
Author | : Adel E. Ahmed Ganaw |
Publisher | : Springer Nature |
Total Pages | : 227 |
Release | : 2021-11-26 |
Genre | : Medical |
ISBN | : 3030813339 |
This book focuses on subarachnoid hemorrhage (SAH), describing in detail the neurophysiology, anatomy, epidemiology, grading, anesthesia management, coiling and interventional treatment of this dangerous disease. Written by leading international experts, it highlights the state-of-the-art techniques for the diagnosis and treatment (non-surgical and surgical) of SAH and the clinical variations. It also examines the reliability of the new techniques versus the standard clinical methods to predict problems related to SAH and its recent diagnosis and management. The book starts with a brief discussion of the epidemiology of SAH, cerebral circulation, anatomy of brain blood vessels and neurophysiology related to this fatal disease. Then, in the following chapters it covers grading of subarachnoid hemorrhage, anesthesia management of SAH, treatment, subarachnoid hemorrhage coiling and radiological intervention. Lastly, it explores surgical treatment of intracranial aneurysms in more detail, and addresses complications, critical care management and headache in SAH, traumatic SAH and prognosis. Featuring numerous images, tables, schema, illustrations and videos, the book is intended for junior and senior anesthesiologists, neuroscientists, intervention radiologists, intensivists and neurosurgeons.
Author | : Stefan Schwab |
Publisher | : Cambridge University Press |
Total Pages | : 579 |
Release | : 2014-06-05 |
Genre | : Medical |
ISBN | : 1139991558 |
New and groundbreaking therapeutic options for the critical care of patients with cerebrovascular disease have improved patient management, minimized morbidity, reduced in-patient care, improved quality of life, and had a positive economic impact on health service provision. This volume integrates these approaches and suggests the best therapy option for all cerebrovascular conditions. The early chapters of the book focus on monitoring techniques and interventions. Subsequent sections address the critical care of a wide range of cerebrovascular diseases: ischemic stroke, intracranial hemorrhage, subarachnoid hemorrhage, arteriovenous malformations, cerebral venous thrombosis and traumatic injury. The editors and authors are internationally recognized experts in their field, and the text is supplemented by tables and illustrations to demonstrate important clinical findings. This book will meet the needs of stroke physicians, neurologists, neurosurgeons, neurointensivists and interventional neuroradiologists seeking to maximize positive outcomes for their patients.
Author | : Daniel Laskowitz |
Publisher | : CRC Press |
Total Pages | : 388 |
Release | : 2016-04-21 |
Genre | : Medical |
ISBN | : 1498766579 |
Traumatic brain injury (TBI) remains a significant source of death and permanent disability, contributing to nearly one-third of all injury related deaths in the United States and exacting a profound personal and economic toll. Despite the increased resources that have recently been brought to bear to improve our understanding of TBI, the developme
Author | : Patricia Bozzetto Ambrosi |
Publisher | : BoD – Books on Demand |
Total Pages | : 358 |
Release | : 2020-05-13 |
Genre | : Medical |
ISBN | : 1789853591 |
“Brain circulation is a true road map that consists of large extended navigation territories and a number of unimagined and undiscovered routes.” Dr. Patricia Bozzetto Ambrosi This book combines an update on the review of cerebrovascular diseases in the form of textbook chapters, which has been carefully reviewed by Dr. Patricia Bozzetto Ambrosi, Drs. Rufai Ahmad and Auwal Abdullahi and Dr. Amit Agrawal, high-performance academic editors with extensive experience in neurodisciplines, including neurology, neurosurgery, neuroscience, and neuroradiology, covering the best standards of neurological practice involving basic and clinical aspects of cerebrovascular diseases. Each topic was carefully revised and prepared using smooth, structured vocabulary, plus superb graphics and scientific illustrations. In emphasizing the most common aspects of cerebrovascular diseases: stroke burden, pathophysiology, hemodynamics, diagnosis, management, repair, and healing, the book is comprehensive but concise and should become the standard reference guide for this neurological approach.
Author | : L. M. Auer |
Publisher | : Walter de Gruyter GmbH & Co KG |
Total Pages | : 700 |
Release | : 2019-05-20 |
Genre | : Medical |
ISBN | : 3110858851 |
No detailed description available for "Timing of Aneurysm Surgery".
Author | : Javier Fandino |
Publisher | : Springer |
Total Pages | : 348 |
Release | : 2014-11-03 |
Genre | : Medical |
ISBN | : 331904981X |
This book contains articles presented at the 12th International Conference on Cerebral Vasospasm, held in Lucerne, Switzerland, in July 2013. The included papers represent a balanced cross-section of the enormous progress achieved in basic and clinical research on aneurysmal subarachnoid hemorrhage and its sequelae, including early neurovascular events and delayed cerebral vasospasm. The section on basic research covers a broad range of aspects, with a special focus on animal models for the study of acute events after experimental subarachnoid hemorrhage. The section on clinical topics encompasses imaging and endovascular management, surgical innovations and techniques, management and monitoring in neurocritical care, the status of clinical trials, and factors involved in aneurysm formation. This edition is of interest not only for basic researchers but also for clinicians who wish to apply state-of-the-art knowledge to the research and management of this devastating condition.
Author | : Ulrich Dirnagl |
Publisher | : Springer Science & Business Media |
Total Pages | : 248 |
Release | : 2013-04-17 |
Genre | : Medical |
ISBN | : 3662054264 |
The successful treatment of acute stroke remains one of the major challenges in clinical medicine. Over the last decades, the understanding of stroke pathophysiology has greatly improved, while the therapeutic options in stroke therapy remain very limited. Today, hyperacute mechanisms of damage, such as excitotoxicity, can be discriminated from delayed ones, such as inflammation and apoptosis. Targeting of inflammation has already been successfully applied in various stroke models, but translation into a clinically efficacious strategy has not been achieved so far. In this book, leading experts in basic cerebrovascular research as well as stroke treatment review the current evidence for and against an important role for inflammation in stroke, and explore the potential of treating or modulating inflammation in stroke therapy.
Author | : John Zhang |
Publisher | : Springer Science & Business Media |
Total Pages | : 420 |
Release | : 2011-07-05 |
Genre | : Medical |
ISBN | : 3709106931 |
The volume includes 75 papers which were presented at the Third International Conference on Intracerebral Hemorrhage, held in Rancho Mirage, California, in March 2010. The topics treated include animal models, pathophysiology of cerebral hemorrhage, experimental treatment for cerebral hemorrhage, cerebral hemorrhage clinical manifestations, prognosis of cerebral hemorrhage, and clinical management. The articles represent the recent advances in hemorrhagic brain injury research presented by highly respected laboratories around the world.
Author | : Peter D. Le Roux |
Publisher | : Saunders |
Total Pages | : 0 |
Release | : 2013 |
Genre | : Medical |
ISBN | : 9781437701678 |
Ideal for neurosurgeons, neurologists, neuroanesthesiologists, and intensivists, Monitoring in Neurocritical Care helps you use the latest technology to more successfully detect deteriorations in neurological status in the ICU. This neurosurgery reference offers in-depth coverage of state-of-the-art management strategies and techniques so you can effectively monitor your patients and ensure the best outcomes. Understand the scientific basis and rationale of particular monitoring techniques and how they can be used to assess neuro-ICU patients. Make optimal use of the most advanced technology, including transcranial Doppler sonography, transcranial color-coded sonography, measurements of jugular venous oxygen saturation, near-infrared spectroscopy, brain electrical monitoring techniques, and intracerebral microdialysis and techniques based on imaging. Apply multimodal monitoring for a more accurate view of brain function, and utilize the latest computer systems to integrate data at the bedside. Access practical information on basic principles, such as quality assurance, ethics, and ICU design. Seamlessly search the full text of Monitoring in Neurocritical Care online at www.expertconsult.com.