Targeting secondary injury in intracerebral haemorrhage--perihaematomal oedema.
Publication/Presentation Date
2-1-2015
Abstract
Perihaematomal oedema (PHO) is an important pathophysiological marker of secondary injury in intracerebral haemorrhage (ICH). In this Review, we describe a novel method to conceptualize PHO formation within the framework of Starling's principle of movement of fluid across a capillary wall. We consider progression of PHO through three stages, characterized by ionic oedema (stage 1) and progressive vasogenic oedema (stages 2 and 3). In this context, possible modifiers of PHO volume and their value in identifying patients who would benefit from therapies that target secondary injury are discussed; the practicalities of using neuroimaging to measure PHO volume are also considered. We examine whether PHO can be used as a predictor of neurological outcome following ICH, and we provide an overview of emerging therapies. Our discussion emphasizes that PHO has clinical relevance both as a therapeutic target, owing to its augmentation of the mass effect of a haemorrhage, and as a surrogate marker for novel interventions that target secondary injury.
Volume
11
Issue
2
First Page
111
Last Page
122
ISSN
1759-4766
Published In/Presented At
Urday, S., Kimberly, W. T., Beslow, L. A., Vortmeyer, A. O., Selim, M. H., Rosand, J., Simard, J. M., & Sheth, K. N. (2015). Targeting secondary injury in intracerebral haemorrhage--perihaematomal oedema. Nature reviews. Neurology, 11(2), 111–122. https://doi.org/10.1038/nrneurol.2014.264
Disciplines
Medicine and Health Sciences | Pediatrics
PubMedID
25623787
Department(s)
Department of Pediatrics
Document Type
Article