When the blood hits your brain: The neurotoxicity of extravasated blood
AuthorStokum, Jesse A.
Cannarsa, Gregory J.
Wessell, Aaron P.
Simard, J. Marc
JournalInternational Journal of Molecular Sciences
MetadataShow full item record
AbstractHemorrhage in the central nervous system (CNS), including intracerebral hemorrhage (ICH), intraventricular hemorrhage (IVH), and aneurysmal subarachnoid hemorrhage (aSAH), re-mains highly morbid. Trials of medical management for these conditions over recent decades have been largely unsuccessful in improving outcome and reducing mortality. Beyond its role in creating mass effect, the presence of extravasated blood in patients with CNS hemorrhage is generally over-looked. Since trials of surgical intervention to remove CNS hemorrhage have been generally unsuc-cessful, the potent neurotoxicity of blood is generally viewed as a basic scientific curiosity rather than a clinically meaningful factor. In this review, we evaluate the direct role of blood as a neuro-toxin and its subsequent clinical relevance. We first describe the molecular mechanisms of blood neurotoxicity. We then evaluate the clinical literature that directly relates to the evacuation of CNS hemorrhage. We posit that the efficacy of clot removal is a critical factor in outcome following surgical intervention. Future interventions for CNS hemorrhage should be guided by the principle that blood is exquisitely toxic to the brain. © 2021 by the authors.
KeywordAneurysmal subarachnoid hemorrhage
Evacuation of CNS hemorrhage
Neurotoxicity of blood
Identifier to cite or link to this itemhttp://hdl.handle.net/10713/15694