Targeting Vascular Neural Network in Intracerebral Hemorrhage

Abstract

Background: Intracerebral hemorrhage (ICH) is a common type of stroke associated with high mortality and morbidity. Recent randomized controlled trials could not prove that the current strategies are effective at improving the final outcome of the ICH patients.

Methods: Here we want to explore potential intervention targets for ICH based on the framework of the vascular neural network (VNN). In this review, a brief history of the evolution of stroke pathophysiology from humoral theory to VNN is discussed.

Results: As current literature on pathophysiology of ICH is mainly focused on neuroprotection, here we want to evolve the central paradigm towards VNN. We stress mechanisms of vascular disruption and impaired blood flow harmony, which are clinically relevant but have received less attention in basic research.

Conclusion: We propose that VNN could be a robust and practical paradigm in both ICH basic research and clinical practice.

Keywords: Intracerebral hemorrhage; hematoma expansion; perihematomal edema; stroke pathophysiology; vascular neural network; venous system.