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2016 ; 17
(4
): 497
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Aneurysmal Subarachnoid Hemorrhage and Neuroinflammation: A Comprehensive Review
#MMPMID27049383
Lucke-Wold BP
; Logsdon AF
; Manoranjan B
; Turner RC
; McConnell E
; Vates GE
; Huber JD
; Rosen CL
; Simard JM
Int J Mol Sci
2016[Apr]; 17
(4
): 497
PMID27049383
show ga
Aneurysmal subarachnoid hemorrhage (SAH) can lead to devastating outcomes
including vasospasm, cognitive decline, and even death. Currently, treatment
options are limited for this potentially life threatening injury. Recent evidence
suggests that neuroinflammation plays a critical role in injury expansion and
brain damage. Red blood cell breakdown products can lead to the release of
inflammatory cytokines that trigger vasospasm and tissue injury. Preclinical
models have been used successfully to improve understanding about
neuroinflammation following aneurysmal rupture. The focus of this review is to
provide an overview of how neuroinflammation relates to secondary outcomes such
as vasospasm after aneurysmal rupture and to critically discuss pharmaceutical
agents that warrant further investigation for the treatment of subarachnoid
hemorrhage. We provide a concise overview of the neuroinflammatory pathways that
are upregulated following aneurysmal rupture and how these pathways correlate to
long-term outcomes. Treatment of aneurysm rupture is limited and few
pharmaceutical drugs are available. Through improved understanding of biochemical
mechanisms of injury, novel treatment solutions are being developed that target
neuroinflammation. In the final sections of this review, we highlight a few of
these novel treatment approaches and emphasize why targeting neuroinflammation
following aneurysmal subarachnoid hemorrhage may improve patient care. We
encourage ongoing research into the pathophysiology of aneurysmal subarachnoid
hemorrhage, especially in regards to neuroinflammatory cascades and the
translation to randomized clinical trials.