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Subarachnoid Hemorrhage: a Review of Experimental Studies on the Microcirculation and the Neurovascular Unit

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Abstract

Increasingly, experimental research in subarachnoid hemorrhage (SAH) has investigated early brain injury and the microcirculation. A number of pathophysiological changes occur in the cerebral microvessels after SAH including altered vasoreactivity, vasoconstriction, inflammation, blood–brain barrier impairment, increased microthrombi, and inversion of neurovascular coupling. This focused review looks at the current state of knowledge regarding the changes that occur in the microcirculation and the neurovascular unit after SAH.

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Abbreviations

ADP:

Adenosine diphosphate

AMPA:

α-Amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid

ASA:

Acetylsalicylic acid

ATP:

Adenosine triphosphate

BBB:

Blood–brain barrier

cGMP:

Cyclic guanosine monophosphate

DCI:

Delayed cerebral ischemia

eNOS:

Endothelial nitric oxide synthase

FITC:

Fluorescein isothiocyanate

IgG:

Immunoglobulin G

IHC:

Immunohistochemistry

iNOS:

Inducible nitric oxide synthase

JNK:

c-Jun N-terminal kinase

MAPK:

Mitogen-activated protein kinase

MMP-9:

Matrix metalloproteinase-9

NFkB:

Nuclear factor-kB

NMDA:

N-methyl-d-aspartate

NO:

Nitric oxide

PAR-1:

Protease-activated receptor-1

PUMA:

p53 upregulated modulator of apoptosis

SAH:

Subarachnoid hemorrhage

siRNA:

Small interfering RNA

TNFα:

Tumor necrosis factor alpha

tPA:

Tissue plasminogen activator

uPA-T:

Urokinase-type plasminogen activator

VDCC:

Voltage-dependent calcium channels

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Acknowledgments

MT receives funding from the Vanier Canada Graduate Scholarship, Canadian Institutes of Health Research, Neurosurgery Research and Education Foundation, and the Joint Cerebrovascular Section of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons. RLM receives grant support from the Brain Aneurysm Foundation, Heart and Stroke Foundation of Canada, and is a stockholder of Edge Therapeutics. RLM is Chief Scientific Officer of Edge Therapeutics.

Conflict of Interest

We declare that we have no conflicts of interest.

Author information

Authors and Affiliations

  1. Division of Neurosurgery, St. Michael’s Hospital, Toronto, ON, Canada

    Michael K. Tso

  2. Institute of Medical Science, University of Toronto, Toronto, ON, Canada

    Michael K. Tso

  3. Division of Neurosurgery, Labatt Family Centre of Excellence in Brain Injury and Trauma Research, Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 30 Bond St., Toronto, ON, M5B 1W8, Canada

    R. Loch Macdonald

  4. Department of Surgery, University of Toronto, Toronto, ON, Canada

    R. Loch Macdonald

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Correspondence to R. Loch Macdonald.

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Special Issue: “Phenotypic transformation of smooth muscle in cerebrovascular disease”

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Tso, M.K., Macdonald, R.L. Subarachnoid Hemorrhage: a Review of Experimental Studies on the Microcirculation and the Neurovascular Unit. Transl. Stroke Res. 5, 174–189 (2014). https://doi.org/10.1007/s12975-014-0323-4

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  • DOI: https://doi.org/10.1007/s12975-014-0323-4

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