文献詳細
文献概要
特集 くも膜下出血のニューフロンティア—病態の再考と治療の進化 Ⅰ くも膜下出血の病態—脳で何が起きているのか?
くも膜下出血後脳障害の病態レビュー
著者: 鈴木秀謙1
所属機関: 1三重大学大学院脳神経外科学
ページ範囲:P.890 - P.898
文献購入ページに移動Point
・くも膜下出血後の脳障害は早期脳損傷と遅発性脳虚血に大別され,全身性合併症により修飾される.
・早期脳損傷はくも膜下出血発症後72時間以内に生じる非医原性脳損傷の総称で,基本的に脳全体に生じる.
・遅発性脳虚血の病態の多くは早期脳損傷と同様であるが,くも膜下出血発症後4日目以降で,かつ基本的に局所的に生じる点が異なる.
・くも膜下出血後の脳障害は早期脳損傷と遅発性脳虚血に大別され,全身性合併症により修飾される.
・早期脳損傷はくも膜下出血発症後72時間以内に生じる非医原性脳損傷の総称で,基本的に脳全体に生じる.
・遅発性脳虚血の病態の多くは早期脳損傷と同様であるが,くも膜下出血発症後4日目以降で,かつ基本的に局所的に生じる点が異なる.
参考文献
1)Suzuki H:What is early brain injury? Transl Stroke Res 6:1-3, 2015 doi:10.1007/s12975-014-0380-8
2)Vergouwen MD, et al:Definition of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage as an outcome event in clinical trials and observational studies:proposal of a multidisciplinary research group. Stroke 41:2391-2395, 2010
3)鈴木秀謙:くも膜下出血の病態はどこまで分かったのか.脳外速報 33:190-194, 2023
4)Suzuki H, et al:Cerebrovascular pathophysiology of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage. Histol Histopathol 36:143-158, 2021
5)Suzuki H, et al:Tenascin-C in brain injuries and edema after subarachnoid hemorrhage:Findings from basic and clinical studies. J Neurosci Res 98:42-56, 2020
6)Suzuki H, et al:Neuroelectric mechanisms of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage. Int J Mol Sci 23:3102, 2022 doi:10.3390/ijms23063102
7)Lauzier DC, et al:Early brain injury after subarachnoid hemorrhage:incidence and mechanisms. Stroke 54:1426-1440, 2023
8)Suzuki H:Inflammation:a good research target to improve outcomes of poor-grade subarachnoid hemorrhage. Transl Stroke Res 10:597-600, 2019
9)Suzuki H:How to promote hemoglobin scavenging or clearance and detoxification in hemorrhagic stroke. Transl Stroke Res 14:625-627, 2023
10)鈴木秀謙,他:重症くも膜下出血に対する治療.脳神外ジャーナル 29:109-115, 2020
11)Kawakita F, et al:Potential roles of matricellular proteins in stroke. Exp Neurol 322:113057, 2019 doi:10.1016/j.expneurol.2019.113057
12)Kanamaru H, et al:Potential therapeutic molecular targets for blood-brain barrier disruption after subarachnoid hemorrhage. Neural Regen Res 14:1138-1143, 2019
13)鈴木秀謙:遅発性脳虚血の病態.Clin Neurosci 41:1306-1310, 2023
14)Kawakita F, et al:Roles of glutamate in brain injuries after subarachnoid hemorrhage. Histol Histopathol 37:1041-1051, 2022
15)Kawakita F, et al:Anti-apoptotic effects of AMPA receptor antagonist perampanel in early brain injury after subarachnoid hemorrhage in mice. Transl Stroke Res 15:462-475, 2024
16)Suzuki H, et al:Effects of new-generation antiepileptic drug prophylaxis on delayed neurovascular events after aneurysmal subarachnoid hemorrhage. Transl Stroke Res 14:899-909, 2023
17)Shimoda M, et al:Early infarction detected by diffusion-weighted imaging in patients with subarachnoid hemorrhage. Acta Neurochir(Wien)152:1197-1205, 2010
掲載誌情報