Open AccessThe Role of Astrogliosis in Formation of the Syrinx in Spinal Cord Injury
Author(s) -
Jacek M. Kwiecień,
Wojciech Dąbrowski,
Jordan R. Yaron,
Liqiang Zhang,
Kathleen H. Delaney,
Alexandra Lucas
Publication year - 2020
Publication title -
current neuropharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.955
H-Index - 73
eISSN - 1875-6190
pISSN - 1570-159X
DOI - 10.2174/1570159x18666200720225222
Subject(s) - astrogliosis , medicine , spinal cord , edema , pathology , syrinx (medicine) , spinal cord injury , inflammation , infiltration (hvac) , syringomyelia , laminectomy , central nervous system , surgery , immunology , physics , psychiatry , thermodynamics
A massive localized trauma to the spinal cord results in complex pathologic events driven by necrosis and vascular damage which in turn leads to hemorrhage and edema. Severe, destructive and very protracted inflammatory response is characterized by infiltration by phagocytic macrophages of a site of injury which is converted into a cavity of injury (COI) surrounded by astroglial reaction mounted by the spinal cord. The tissue response to the spinal cord injury (SCI) has been poorly understood but the final outcome appears to be a mature syrinx filled with the cerebrospinal fluid with related neural tissue loss and permanent neurologic deficits. This paper reviews known pathologic mechanisms involved in the formation of the COI after SCI and discusses the integrative role of reactive astrogliosis in mechanisms involved in the removal of edema after the injury. A large proportion of edema fluid originating from the trauma and then from vasogenic edema related to persistent severe inflammation, may be moved into the COI in an active process involving astrogliosis and specifically over-expressed aquaporins.