Prevention and treatment of cerebral vasospasm following aneurysmal subarachnoid hemorrhage
Cerebral vasospasm after aneurysmal subarachnoid hemorrhage (aSAH) remains a significant cause of morbidity and mortality. Post-hemorrhage cerebral vasospasm (PHCV) occurs through a complex pathophysiology, and numerous pharmacologic agents, including vasodilators, anti-inflammatories, an...
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Academia.edu Journals
2023-12-01
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| Series: | Academia Biology |
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| author | Kyle McGrath Grace Hey Ghaidaa Ebrahim Noah Gilberstadt David Mahan Brandon Lucke-Wold |
| author_facet | Kyle McGrath Grace Hey Ghaidaa Ebrahim Noah Gilberstadt David Mahan Brandon Lucke-Wold |
| author_sort | Kyle McGrath |
| collection | DOAJ |
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Cerebral vasospasm after aneurysmal subarachnoid hemorrhage (aSAH) remains a significant cause of morbidity and mortality. Post-hemorrhage cerebral vasospasm (PHCV) occurs through a complex pathophysiology, and numerous pharmacologic agents, including vasodilators, anti-inflammatories, and fibrinolytics, as well as endovascular techniques have been used to prevent and/or treat PHCV. Nimodipine continues to be the only agent with level 1 evidence, but other vasodilators have demonstrated promising results. Endovascular therapy likely has a role in treating severe/refractory PHCV, but randomized trials are needed to establish stronger evidence for this therapy. Numerous preclinical investigations highlight novel targets related to the immune response that could prove effective at improving outcomes in clinical trials. Further investigation of the glymphatic system and its role in PHCV pathogenesis could result in novel pharmacologic targets. Future trials of these therapies and combinations of existing therapies are needed, and functional outcomes should be included as an endpoint. Further exploration of the neuroinflammatory reaction following aSAH will continue to identify targetable molecules involved in PHCV pathogenesis. |
| format | Article |
| id | doaj-art-32235728fb1d4459b8de64edb2acca59 |
| institution | Kabale University |
| issn | 2837-4010 |
| language | English |
| publishDate | 2023-12-01 |
| publisher | Academia.edu Journals |
| record_format | Article |
| series | Academia Biology |
| spelling | doaj-art-32235728fb1d4459b8de64edb2acca592025-02-11T00:38:17ZengAcademia.edu JournalsAcademia Biology2837-40102023-12-011410.20935/AcadBiol6157Prevention and treatment of cerebral vasospasm following aneurysmal subarachnoid hemorrhageKyle McGrath0Grace Hey1Ghaidaa Ebrahim2Noah Gilberstadt3David Mahan4Brandon Lucke-Wold5College of Medicine, University of Florida, Gainesville, FL, USA.College of Medicine, University of Florida, Gainesville, FL, USA.Lillian S. Wells Department of Neurosurgery, University of Florida, Gainesville, FL, USA.College of Medicine, University of Florida, Gainesville, FL, USA.College of Medicine, University of Florida, Gainesville, FL, USA.Lillian S. Wells Department of Neurosurgery, University of Florida, Gainesville, FL, USA. Cerebral vasospasm after aneurysmal subarachnoid hemorrhage (aSAH) remains a significant cause of morbidity and mortality. Post-hemorrhage cerebral vasospasm (PHCV) occurs through a complex pathophysiology, and numerous pharmacologic agents, including vasodilators, anti-inflammatories, and fibrinolytics, as well as endovascular techniques have been used to prevent and/or treat PHCV. Nimodipine continues to be the only agent with level 1 evidence, but other vasodilators have demonstrated promising results. Endovascular therapy likely has a role in treating severe/refractory PHCV, but randomized trials are needed to establish stronger evidence for this therapy. Numerous preclinical investigations highlight novel targets related to the immune response that could prove effective at improving outcomes in clinical trials. Further investigation of the glymphatic system and its role in PHCV pathogenesis could result in novel pharmacologic targets. Future trials of these therapies and combinations of existing therapies are needed, and functional outcomes should be included as an endpoint. Further exploration of the neuroinflammatory reaction following aSAH will continue to identify targetable molecules involved in PHCV pathogenesis.https://www.academia.edu/111154260/Prevention_and_treatment_of_cerebral_vasospasm_following_aneurysmal_subarachnoid_hemorrhage |
| spellingShingle | Kyle McGrath Grace Hey Ghaidaa Ebrahim Noah Gilberstadt David Mahan Brandon Lucke-Wold Prevention and treatment of cerebral vasospasm following aneurysmal subarachnoid hemorrhage Academia Biology |
| title | Prevention and treatment of cerebral vasospasm following aneurysmal subarachnoid hemorrhage |
| title_full | Prevention and treatment of cerebral vasospasm following aneurysmal subarachnoid hemorrhage |
| title_fullStr | Prevention and treatment of cerebral vasospasm following aneurysmal subarachnoid hemorrhage |
| title_full_unstemmed | Prevention and treatment of cerebral vasospasm following aneurysmal subarachnoid hemorrhage |
| title_short | Prevention and treatment of cerebral vasospasm following aneurysmal subarachnoid hemorrhage |
| title_sort | prevention and treatment of cerebral vasospasm following aneurysmal subarachnoid hemorrhage |
| url | https://www.academia.edu/111154260/Prevention_and_treatment_of_cerebral_vasospasm_following_aneurysmal_subarachnoid_hemorrhage |
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