Open AccessEarly brain injury and subarachnoid hemorrhage: Where are we at present?
Author(s) -
Tumul Chowdhury,
Hari H. Dash,
Ronald B. Cappellani,
Jayesh Daya
Publication year - 2013
Publication title -
saudi journal of anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.416
H-Index - 24
eISSN - 1658-354X
pISSN - 0975-3125
DOI - 10.4103/1658-354x.114047
Subject(s) - medicine , subarachnoid hemorrhage , pathophysiology , mechanism (biology) , vasospasm , bleed , ischemia , intensive care medicine , intracranial pressure , therapeutic modalities , review article , neuroscience , anesthesia , surgery , pathology , philosophy , epistemology , biology
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.