Venous system in acute brain injury: Mechanisms of pathophysiological change and function

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• 作者：Sheng Chen^a ; ¹ ; Yujie Chen^b ; ¹ ; Liang Xu^a ; Nathanael Matei^c ; Jiping Tang^c ; Hua Feng^b ; John H. Zhang^c ; ^{johnzhang3910@yahoo.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Acute brain injury ; Vein ; Pathophysiology ; Vascular neural network
• 刊名：Experimental Neurology
• 出版年：2015
• 出版时间：October 2015
• 年：2015
• 卷：272
• 期：Complete
• 页码：4-10
• 全文大小：795 K

文摘

Cerebral vascular injury is a major component of acute brain injury. Currently, neuroprotective strategies primarily focus on the recanalization of cerebral arteries and capillaries, and the protection of insulted neurons. Hitherto, the role of vein drainage in the pathophysiology of acute brain injury has been overlooked, due to an under appreciation of the magnitude of the impact of veins in circulation. In this review, we summarize the changes in the vein morphology and functions that are known, or likely to occur related to acute brain injury, and aim to advance the therapeutic management of acute brain injury by shifting the focus from reperfusion to another term: recirculation. Recent progress in the neurobiological understanding of the vascular neural network has demonstrated that cerebral venous systems are able to respond to acute brain injury by regulating the blood flow disharmony following brain edema, blood brain barrier disruption, ischemia, and hemorrhage. With the evidence presented in this review, future clinical management of acutely brain injured patients will expand to include the recirculation concept, establishing a harmony between arterial and venous systems, in addition to the established recanalization and reperfusion strategies.