Perihematomal Edema After Intracerebral Hemorrhage: An Update on Pathogenesis, Risk Factors, and Therapeutic Advances

Front Immunol. 2021 Oct 19:12:740632. doi: 10.3389/fimmu.2021.740632. eCollection 2021.

Abstract

Intracerebral hemorrhage (ICH) has one of the worst prognoses among patients with stroke. Surgical measures have been adopted to relieve the mass effect of the hematoma, and developing targeted therapy against secondary brain injury (SBI) after ICH is equally essential. Numerous preclinical and clinical studies have demonstrated that perihematomal edema (PHE) is a quantifiable marker of SBI after ICH and is associated with a poor prognosis. Thus, PHE has been considered a promising therapeutic target for ICH. However, the findings derived from existing studies on PHE are disparate and unclear. Therefore, it is necessary to classify, compare, and summarize the existing studies on PHE. In this review, we describe the growth characteristics and relevant underlying mechanism of PHE, analyze the contributions of different risk factors to PHE, present the potential impact of PHE on patient outcomes, and discuss the currently available therapeutic strategies.

Keywords: intracerebral hemorrhage; neuroinflammation; pathophysiology; perihematomal edema; therapies.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Brain / diagnostic imaging
  • Brain / pathology*
  • Brain Edema / etiology
  • Brain Edema / physiopathology*
  • Brain Edema / prevention & control
  • Cerebral Hemorrhage / complications
  • Cerebral Hemorrhage / physiopathology*
  • Cerebral Hemorrhage / therapy
  • Glyburide / therapeutic use
  • Hematoma / etiology
  • Hematoma / physiopathology*
  • Hematoma / prevention & control
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Magnetic Resonance Imaging
  • Neurogenic Inflammation
  • Risk Factors

Substances

  • Hypoglycemic Agents
  • Glyburide