Universität zu Köln

van Lieshout, Jasper H., Dibue-Adjei, Maxine, Cornelius, Jan F., Slotty, Philipp J., Schneider, Toni, Restin, Tanja ORCID: 0000-0002-8816-6069, Boogaarts, Hieronymus D., Steiger, Hans-Jakob, Petridis, Athanasios K. and Kamp, Marcel A. (2018). An introduction to the pathophysiology of aneurysmal subarachnoid hemorrhage. Neurosurg. Rev., 41 (4). S. 917 - 931. NEW YORK: SPRINGER. ISSN 1437-2320

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Abstract

Pathophysiological processes following subarachnoid hemorrhage (SAH) present survivors of the initial bleeding with a high risk of morbidity and mortality during the course of the disease. As angiographic vasospasm is strongly associated with delayed cerebral ischemia (DCI) and clinical outcome, clinical trials in the last few decades focused on prevention of these angiographic spasms. Despite all efforts, no new pharmacological agents have shown to improve patient outcome. As such, it has become clear that our understanding of the pathophysiology of SAH is incomplete and we need to reevaluate our concepts on the complex pathophysiological process following SAH. Angiographic vasospasm is probably important. However, a unifying theory for the pathophysiological changes following SAH has yet not been described. Some of these changes may be causally connected or present themselves as an epiphenomenon of an associated process. A causal connection between DCI and early brain injury (EBI) would mean that future therapies should address EBI more specifically. If the mechanisms following SAH display no causal pathophysiological connection but are rather evoked by the subarachnoid blood and its degradation production, multiple treatment strategies addressing the different pathophysiological mechanisms are required. The discrepancy between experimental and clinical SAH could be one reason for unsuccessful translational results.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code van Lieshout, Jasper H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Dibue-Adjei, Maxine UNSPECIFIED UNSPECIFIED UNSPECIFIED Cornelius, Jan F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Slotty, Philipp J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schneider, Toni UNSPECIFIED UNSPECIFIED UNSPECIFIED Restin, Tanja UNSPECIFIED orcid.org/0000-0002-8816-6069 UNSPECIFIED Boogaarts, Hieronymus D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Steiger, Hans-Jakob UNSPECIFIED UNSPECIFIED UNSPECIFIED Petridis, Athanasios K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kamp, Marcel A. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-172215
DOI:	10.1007/s10143-017-0827-y
Journal or Publication Title:	Neurosurg. Rev.
Volume:	41
Number:	4
Page Range:	S. 917 - 931
Date:	2018
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1437-2320
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language DELAYED CEREBRAL-ISCHEMIA; EARLY BRAIN-INJURY; INTERCELLULAR-ADHESION MOLECULE-1; PROLONGED-RELEASE IMPLANTS; SUB-ARACHNOID HEMORRHAGE; NITRIC-OXIDE SYNTHASE; C-REACTIVE PROTEIN; PERFUSION COMPUTERIZED-TOMOGRAPHY; NEWTON NIMODIPINE MICROPARTICLES; CORTICAL SPREADING DEPRESSION Multiple languages Clinical Neurology; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/17221