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dc.contributor.authorGeraghty, Joseph, R.
dc.contributor.authorTestai, Fernando, D.
dc.date.accessioned2018-06-19T20:18:36Z
dc.date.available2018-06-19T20:18:36Z
dc.date.issued2017-10-23
dc.identifier.issn1523-3804
dc.identifier.other10.1007/s11883-017-0690-x
dc.identifier.urihttp://hdl.handle.net/10027/22355
dc.descriptionThis is a post-peer-review, pre-copyedit version of an article published in Current Atherosclerosis Reports. The final authenticated version is available online at: http://dx.doi.org/10.1007/s11883-017-0690-x.en_US
dc.description.abstractPURPOSE OF REVIEW: Delayed cerebral ischemia (DCI) is common after subarachnoid hemorrhage (SAH) and represents a significant cause of poor functional outcome. DCI was mainly thought to be caused by cerebral vasospasm; however, recent clinical trials have been unable to confirm this hypothesis. Studies in humans and animal models have since supported the notion of a multifactorial pathophysiology of DCI. This review summarizes some of the main mechanisms under investigation including cerebral vascular dysregulation, microthrombosis, cortical spreading depolarizations, and neuroinflammation. RECENT FINDINGS: Recent guidelines have differentiated between DCI and angiographic vasospasm and have highlighted roles of the microvasculature, coagulation and fibrinolytic systems, cortical spreading depressions, and the contribution of the immune system to DCI. Many therapeutic interventions are underway in both preclinical and clinical studies to target these novel mechanisms as well as studies connecting these mechanisms to one another. Summary: Clinical trials to date have been largely unsuccessful at preventing or treating DCI after SAH. The only successful pharmacologic intervention is the calcium channel antagonist, nimodipine. Recent studies have provided evidence that cerebral vasospasm is not the sole contributor to DCI and that additional mechanisms may play equal if not more important roles.en_US
dc.language.isoen_USen_US
dc.publisherCurrent Medicine Groupen_US
dc.subjectCortical spreading depolarizationen_US
dc.subjectDelayed cerebral ischemiaen_US
dc.subjectNeuroinflammationen_US
dc.titleDelayed Cerebral Ischemia after Subarachnoid Hemorrhage: Beyond Vasospasm and Towards a Multifactorial Pathophysiology.en_US
dc.typeArticleen_US
dc.identifier.citationGeraghty, J. R. and Testai, F. D. Delayed Cerebral Ischemia after Subarachnoid Hemorrhage: Beyond Vasospasm and Towards a Multifactorial Pathophysiology. Current Atherosclerosis Reports. 2017. 19(12). 10.1007/s11883-017-0690-x.en_US


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