脑蛛网膜下腔出血

脑蛛网膜下腔出血第一页，共二十一页，2022年，8月28日OutlineIntroduction;Researchpurposes;Materialandmethod;ResultandDiscussion;Evaluationandoutlook;Conclusion.第二页，共二十一页，2022年，8月28日ReferencesCahillWJ,CalvertJH,ZHangJH,etal.Mechanismsofearlybraininjuryaftersubarachnoidhemorrhage[J].JCerebBloodFlowMetab,2006,26(11):1341-1353E.Koniewska,R.Michaliketal.Mechanismsofvasculardysfunctionaftersubarachnoidhemorrhage[J].J.PhysiologyandPharmacology,2006,57,11,145.160WestermAierT,Jaussa,EriskatJ,etal.Time-courseofcerebralperfusionandtissueoxygenationinthefirst6hafterexperimentalsubarachnoidhemorrhageinrats[J].JCerebBloodFlowMetab,2009,29(4):771-779BenjaminFriedrich,etal.Experimentalsubarachnoidhemorrhagecausesearlyandlong-lastingmicroarterialconstrictionandmicrothrombosis:anin-vivomicroscopystudy.JCerebFlow

Metab.2012,32(3):447-455IshikawaMami;KusakaGen;YamaguchiNoriyuki.Plateletandleukocyteadhesioninthemicrovasculartureatthecerebralsurfaceimmediatelyaftersubarachnoidhemorrhage,J.Neurosurgery,2009,64(3):546-553DanielZ,MuhammadF.etal.Delayedischemiaaftersubarachnoidhemorrhage:resultofvasospasmaloneorabroader[J],J.VascMed200712:243第三页，共二十一页，2022年，8月28日IntroductionSubarachnoidHemorrhage(SAH):Asubtypeofstrokewithaparticularlyhighmorbidityandmortality.EarlyBrainInjury(EBI):Occurswithin72haftertheinitialbleed;Noeffectivetreatmentisavailable;Mechanismshaverecentlystartedtobeunderstood.第四页，共二十一页，2022年，8月28日CAHILLWJ,CALVERTJH,ZHANGJH,etal.Mechanismsofearlybraininjuryaftersubarachnoidhemorrhage[J].JCerebBloodFlowMetab,2006,26(11):1341-1353第五页，共二十一页，2022年，8月28日E.KONIEWSKA,R.MICHALIKetal.MECHANISMSOFVASCULARDYSFUNCTIONAFTERSUBARACHNOIDHEMORRHAGE[J]J.PHYSIOLOGYANDPHARMACOLOGY2006,57,Suppl11,145.160第六页，共二十一页，2022年，8月28日WESTERMAIERT,JAUSSA,ERISKATJ,etal.Time-courseofcerebralperfusionandtissueoxygenationinthefirst6hafterexperimentalsubarachnoidhemorrhageinrats[J].JCerebBloodFlowMetab,2009,29(4):771-779第七页，共二十一页，2022年，8月28日ResearchpurposesCPPindependentInvestigateinvivoAlterationsonmicrocirculation?Whether/When/Where/What/HowRelationshipwithmicrothrombiEarlyperfusiondeficits

CBFreduction第八页，共二十一页，2022年，8月28日MaterialandMethod

CWpmodel;Cranialwindow;Intravitalfluorescencemicroscopy.

第九页，共二十一页，2022年，8月28日MicrovascularConstriction:Numerousconstrictedarterioleswereobserved,incontracttovenules;Distributionofseveritychangedovertime.Result-1BenjaminFriedrich,etal.Experimentalsubarachnoidhemorrhagecausesearlyandlong-lastingmicroarterialconstrictionandmicrothrombosis:anin-vivomicroscopystudy.JCerebFlowMetab.2012,32(3):447-455第十页，共二十一页，2022年，8月28日Result1MicrovascularConstriction:Numerousconstrictedarterioleswereobserved,incontracttovenules;Distributionofseveritychangedovertime.Thesmallestarteriolesaremostseverelyaffectedbymicrovasospasm.BenjaminFriedrich,etal.Experimentalsubarachnoidhemorrhagecausesearlyandlong-lastingmicroarterialconstrictionandmicrothrombosis:anin-vivomicroscopystudy.JCerebFlowMetab.2012,32(3):447-455第十一页，共二十一页，2022年，8月28日Result-1Microthrombi:Arteriolarconstrictionsoccurfirstandthentriggermicrothrombosis;Theseverityofconstrictionwaspositivelycorrelatedwiththefrequencyofmicro-thrombiBenjaminFriedrich,etal.Experimentalsubarachnoidhemorrhagecausesearlyandlong-lastingmicroarterialconstrictionandmicrothrombosis:anin-vivomicroscopystudy.JCerebFlowMetab.2012,32(3):447-455第十二页，共二十一页，2022年，8月28日SummaryLong-lastinghemodynamicalterationsatthemicrocirculatorylevelmaybeanimportantmechanismforthedevelopmentofearlyposthemorrhagicischemia.第十三页，共二十一页，2022年，8月28日P-selectinandApocyninP-selectin

Platelet-Leukocyte

rollingandadhesionEndothelial–LeukocyteadhesionPlatelet-Endothelialadhesionnon-P-selectin60%40%blockerPlatelet

P-selectinEndothelial

P-selectinLeukocyte

PSGL-1NAD(P)Hoxidase

Apocynin第十四页，共二十一页，2022年，8月28日Result-2Platelet-leukocyte-endothelialcellinteractionswereobservedmainlyinthepostcapillaryvenulesimmediatelyafterSAH.TreatmentwithP-selectin-blockingantibodybeforeSAHreducedrollingandadherentplateletsalmosttobaselinelevels.Treatmentwithapocynin

beforeSAHreducedplateletadhesionbyonehalf.IshikawaMami;KusakaGen;YamaguchiNoriyuki.Plateletandleukocyteadhesioninthemicrovasculartureatthecerebralsurfaceimmediatelyaftersubarachnoidhemorrhage,J.Neurosurgery,2009第十五页，共二十一页，2022年，8月28日DiscussionP-selectin

Platelet-Leukocyte

rollingandadhesionEndothelial–LeukocyteadhesionPlatelet-Endothelialadhesionnon-P-selectin60%40%blockerPlatelet

P-selectin;Endothelial

P-selectinLeukocyte

PSGL-1NAD(P)Hoxidase

ApocyninApocynin第十六页，共二十一页，2022年，8月28日SummaryP-selectinandNAD(P)HoxidaseparticipateintheearlymicrovascularresponsestoSAH.第十七页，共二十一页，2022年，8月28日EvaluationAdvantages:ProvideMorphologicalevidence;Helpverifymechanisms;Invivo;Dynamicchangesatearlytime;Microcirculation;Retainedduramater;Limitations:superficialstructuresonly;decompressioncraniectomy;detailedmolecularmechanisms;第十八页，共二十一页，2022年，8月28日OutlookThedistincteventsoccurinmicro-arteriolesandmicro-venules?whichpathwaysplayadominantrole?Otherpotentialrolesintheinductionofmicrocirculationdeficit?Combinewithmolecularbiologystudy?Secrethiddenbehindthephen