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Translational Stroke Research

, Volume 3, Supplement 1, pp 52–61 | Cite as

The Molecular Mechanisms that Promote Edema After Intracerebral Hemorrhage

  • Daniel Bodmer
  • Kerry A. Vaughan
  • Brad E. Zacharia
  • Zachary L. Hickman
  • E. Sander Connolly
Review Article

Abstract

Intracerebral hemorrhage (ICH) is a devastating type of stroke with no effective therapies. Clinical advances in ICH treatment are limited by an incomplete understanding of the molecular mechanisms responsible for secondary injury and poor outcome. Increasing evidence suggests that cerebral edema is a major contributor to secondary injury and poor outcome in ICH. ICH activates specific signaling pathways that promote edema and damage neuronal tissue. By increasing our understanding of these pathways, we may be able to target them pharmaceutically to reduce edema in ICH patients. In this review, we focus on three major signaling pathways that promote edema after ICH: (1) the coagulation cascade and thrombin, (2) the inflammatory response and matrix metalloproteinases, and (3) the complement cascade and hemoglobin toxicity. We will describe the experimental evidence that confirms these pathways promote edema in ICH, discuss potential targets for new therapies, and comment on important directions for future research.

Keywords

Hemorrhagic stroke Intracerebral hemorrhage Cerebral edema Thrombin Complement system Inflammation 

Notes

Acknowledgments

We apologize to authors whose work could not be cited due to space limitations. E.S.C. is supported by National Institutes of Health funding.

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Daniel Bodmer
    • 1
  • Kerry A. Vaughan
    • 1
  • Brad E. Zacharia
    • 1
    • 2
  • Zachary L. Hickman
    • 1
  • E. Sander Connolly
    • 1
  1. 1.Department of Neurological Surgery, The Neurological InstituteColumbia University College of Physicians and SurgeonsNew YorkUSA
  2. 2.Department of NeurosurgeryColumbia UniversityNew YorkUSA

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