White Matter Injury after Intracerebral Hemorrhage: Pathophysiology and Therapeutic Strategies.

White Matter Injury after Intracerebral Hemorrhage: Pathophysiology and Therapeutic Strategies.
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脑出血后白质损伤:病理生理学和治疗策略

DOI:
10.3389/fnhum.2017.00422
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发表时间:
2017
影响因子:
2.9
通讯作者:
You C
You C
中科院分区:
医学3区
文献类型:
--
作者:
Tao C;Hu X;Li H;You C

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脑出血(ICH)占所有类型卒中的10%-30%。由于复杂的病理生理机制,脑实质内的出血导致灰质(GM)破坏以及近端或远端白色质(WM)损伤。由于WM具有独特的细胞结构、血液供应模式和相应的功能,其对卒中的反应可能与GM不同,因此更好地了解ICH后脑卒中的特征是必要的,并可能为治疗选择提供新的思路。目前使用组织学、放射学和化学生物标志物的证据清楚地证实了ICH后脑出血的时空分布。虽然某些类型的病理损伤,如炎症,氧化和神经兴奋性损伤的WM已被确定,确切的分子机制仍不清楚。在这篇综述文章中,我们简要介绍了脑WM的组成和生理功能,总结了证据,并重点介绍了潜在的病理生理机制和治疗策略。
Intracerebral hemorrhage (ICH) accounts for 10%–30% of all types of stroke. Bleeding within the brain parenchyma causes gray matter (GM) destruction as well as proximal or distal white matter (WM) injury (WMI) due to complex pathophysiological mechanisms. Because WM has a distinct cellular architecture, blood supply pattern and corresponding function, and its response to stroke may vary from that of GM, a better understanding of the characteristics of WMI following ICH is essential and may shed new light on treatment options. Current evidence using histological, radiological and chemical biomarkers clearly confirms the spatio-temporal distribution of WMI post- ICH. Although certain types of pathological damage such as inflammatory, oxidative and neuro-excitotoxic injury to WM have been identified, the exact molecular mechanisms remain unclear. In this review article, we briefly describe the constitution and physiological function of brain WM, summarize evidence regarding WMI, and focus on the underlying pathophysiological mechanisms and therapeutic strategies.
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