Pathophysiology and therapy of experimental stroke

被引：372

作者：

Konstantin-Alexander Hossmann ^{[1
]}

机构：

[1] Max-Planck-Institute for Neurological Research, Cologne

[2] Max-Planck-Institute for Neurological Research, D-50931, Cologne

来源：

Cellular and Molecular Neurobiology | 2006年 / 26卷 / 7期

关键词：

Collateral circulation; Focal ischemia; Hemodynamic mechanisms; Hemodynamic reserve; Infarct progression; Ischemic cell death; Molecular mechanisms; Neuroprotection; Penumbra; Regeneration; Thrombolysis; Viability thresholds;

D O I：

10.1007/s10571-006-9008-1

中图分类号：

学科分类号：

摘要：

1. Stroke is the neurological evidence of a critical reduction of cerebral blood flow in a circumscribed part of the brain, resulting from the sudden or gradually progressing obstruction of a large brain artery. Treatment of stroke requires the solid understanding of stroke pathophysiology and involves a broad range of hemodynamic and molecular interventions. This review summarizes research that has been carried out in many laboratories over a long period of time, but the main focus will be on own experimental research. 2. The first chapter deals with the hemodynamics of focal ischemia with particular emphasis on the collateral circulation of the brain, the regulation of blood flow and the microcirculation. In the second chapter the penumbra concept of ischemia is discussed, providing a detailed list of the physiological, biochemical and structural viability thresholds of ischemia and examples of how these thresholds can be applied for imaging the penumbra. The third chapter summarizes the pathophysiology of infarct progression, focusing on the role of peri-infarct depolarisation, the multitude of putative molecular injury pathways, brain edema and inflammation. Finally, the fourth chapter provides an overview of currently discussed therapeutic approaches, notably the effect of mechanical or thrombolytic reperfusion, arteriogenesis, pharmacological neuroprotection, ischemic preconditioning and regeneration. 3. The main emphasis of the review is placed on the balanced differentiation between hemodynamic and molecular factors contributing to the manifestation of ischemic injury in order to provide a rational basis for future therapeutic interventions. © 2006 Springer Science+Business Media, Inc.

引用

页码：1057 / 1083

页数：26

共 130 条

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