Vascular disruption and blood–brain barrier dysfunction in intracerebral hemorrhage

Fluids and Barriers of the CNS

Guohua Xi⁴  Ya Hua⁴  Anuska V Andjelkovic¹  Jianming Xiang⁴  Ningna Zhou³  Richard F Keep² 

[1] Department of Pathology, University of Michigan, Ann Arbor, USA;Department of Molecular & Integrative Physiology, University of Michigan, Ann Arbor, USA;Department of Pharmacology, Yunnan University of Traditional Chinese Medicine, Kunming, China;Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan 48109-2200, USA

关键词: Iron;    Hemoglobin;    Thrombin;    Tight junction;    Endothelium;    Blood–brain barrier;    Hematoma expansion;    Intracerebral hemorrhage;   

Others  :  1098260
DOI  :  10.1186/2045-8118-11-18

 received in 2014-07-15, accepted in 2014-08-07,  发布年份 2014

【 摘 要 】

This article reviews current knowledge of the mechanisms underlying the initial hemorrhage and secondary blood–brain barrier (BBB) dysfunction in primary spontaneous intracerebral hemorrhage (ICH) in adults. Multiple etiologies are associated with ICH, for example, hypertension, Alzheimer’s disease, vascular malformations and coagulopathies (genetic or drug-induced). After the initial bleed, there can be continued bleeding over the first 24 hours, so-called hematoma expansion, which is associated with adverse outcomes. A number of clinical trials are focused on trying to limit such expansion. Significant progress has been made on the causes of BBB dysfunction after ICH at the molecular and cell signaling level. Blood components (e.g. thrombin, hemoglobin, iron) and the inflammatory response to those components play a large role in ICH-induced BBB dysfunction. There are current clinical trials of minimally invasive hematoma removal and iron chelation which may limit such dysfunction. Understanding the mechanisms underlying the initial hemorrhage and secondary BBB dysfunction in ICH is vital for developing methods to prevent and treat this devastating form of stroke.

【 授权许可】

   
2014 Keep et al.; licensee BioMed Central Ltd.

【 图 表 】

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