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Review
. 2019 Aug 29;19(10):78.
doi: 10.1007/s11910-019-0990-3.

Early Brain Injury After Poor-Grade Subarachnoid Hemorrhage

Verena Rass  1 , Raimund Helbok  2
Affiliations
Review

Early Brain Injury After Poor-Grade Subarachnoid Hemorrhage

Verena Rass et al. Curr Neurol Neurosci Rep. .

Abstract

Purpose of review: Over the last years, the focus of clinical and animal research in subarachnoid hemorrhage (SAH) shifted towards the early phase after the bleeding based on the association of the early injury pattern (first 72 h) with secondary complications and poor outcome. This phase is commonly referenced as early brain injury (EBI). In this clinical review, we intended to overview commonly used definitions of EBI, underlying mechanisms, and potential treatment implications.

Recent findings: We found a large heterogeneity in the definition used for EBI comprising clinical symptoms, neuroimaging parameters, and advanced neuromonitoring techniques. Although specific treatments are currently not available, therapeutic interventions are aimed at ameliorating EBI by improving the energy/supply mismatch in the early phase after SAH. Future research integrating brain-derived biomarkers is warranted to improve our pathophysiologic understanding of EBI in order to ameliorate early injury patterns and improve patients' outcomes.

Keywords: Early brain injury; Neuroimaging; Neuromonitoring; Subarachnoid hemorrhage; Treatment.

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Conflict of interest statement

Raimund Helbok received speaker’s honoraria of BARD Medical and ZOLL Medical and serves in the advisory board of the Intrepid trial (Bard Medical). Verena Rass declares no potential conflicts of interest.

Figures

Fig. 1
Fig. 1
The complex pathophysiologic mechanisms contributing to early brain injury (EBI) after subarachnoid hemorrhage (SAH). Definitions of EBI used in the clinical setting are heterogenous and include clinical symptoms, neuroimaging parameters, and advanced neuromonitoring techniques. ICP = intracranial pressure, CPP = cerebral perfusion pressure, BBB = blood-brain barrier
See this image and copyright information in PMC

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