Targeting secondary injury in intracerebral haemorrhage-perihaematomal oedema

Sebastian Urday, W. Taylor Kimberly, Lauren A. Beslow, Alexander Vortmeyer, Magdy H. Selim, Jonathan Rosand, J. Marc Simard, Kevin N. Sheth

Research output: Contribution to journalReview article

77 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)111-122
Number of pages12
JournalNature Reviews Neurology
Volume11
Issue number2
DOIs
StatePublished - Jan 1 2015
Externally publishedYes

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Cerebral Hemorrhage
Edema
Wounds and Injuries
Starlings
Neuroimaging
Therapeutics
Biomarkers
Hemorrhage

ASJC Scopus subject areas

  • Clinical Neurology
  • Cellular and Molecular Neuroscience

Cite this

Urday, S., Kimberly, W. T., Beslow, L. A., Vortmeyer, A., Selim, M. H., Rosand, J., ... 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

Targeting secondary injury in intracerebral haemorrhage-perihaematomal oedema. / Urday, Sebastian; Kimberly, W. Taylor; Beslow, Lauren A.; Vortmeyer, Alexander; Selim, Magdy H.; Rosand, Jonathan; Simard, J. Marc; Sheth, Kevin N.

In: Nature Reviews Neurology, Vol. 11, No. 2, 01.01.2015, p. 111-122.

Research output: Contribution to journalReview article

Urday, S, Kimberly, WT, Beslow, LA, Vortmeyer, A, Selim, MH, Rosand, J, Simard, JM & Sheth, KN 2015, 'Targeting secondary injury in intracerebral haemorrhage-perihaematomal oedema', Nature Reviews Neurology, vol. 11, no. 2, pp. 111-122. https://doi.org/10.1038/nrneurol.2014.264
Urday, Sebastian ; Kimberly, W. Taylor ; Beslow, Lauren A. ; Vortmeyer, Alexander ; Selim, Magdy H. ; Rosand, Jonathan ; Simard, J. Marc ; Sheth, Kevin N. / Targeting secondary injury in intracerebral haemorrhage-perihaematomal oedema. In: Nature Reviews Neurology. 2015 ; Vol. 11, No. 2. pp. 111-122.
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