Microclots in subarachnoid hemorrhage: an underestimated factor in delayed cerebral ischemia?

Molly Monsour; Davide Marco Croci; Siviero Agazzi

doi:10.1016/j.clineuro.2022.107330

Microclots in subarachnoid hemorrhage: an underestimated factor in delayed cerebral ischemia?

Clin Neurol Neurosurg. 2022 Aug:219:107330. doi: 10.1016/j.clineuro.2022.107330. Epub 2022 Jun 9.

Authors

Molly Monsour¹, Davide Marco Croci², Siviero Agazzi³

Affiliations

¹ University of South Florida Morsani College of Medicine, 12901 Bruce B. Downs Blvd., Tampa, FL 33612, USA.
² Department of Neurosurgery and Brain Repair, University of South Florida, Morsani College of Medicine, Tampa, FL, USA. Electronic address: davidecroci@usf.edu.
³ Department of Neurosurgery and Brain Repair, University of South Florida, Morsani College of Medicine, Tampa, FL, USA.

PMID: 35700661
DOI: 10.1016/j.clineuro.2022.107330

Abstract

Subarachnoid hemorrhage has a poor prognosis due to the wide array of associated complications such as vasospasm, early brain injury, cortical spreading depression, oxidative stress, inflammation, and apoptosis. Each of these complications increases the risk of delayed cerebral ischemia (DCI), but recent research has suggested microclots play a substantial role in DCI incidence. This review will focus on the underlying inflammatory and coagulative mechanisms of microthrombosis while also outlining the current literature relating microclot burden to DCI. With a better understanding DCI pathophysiology as it relates to microthrombosis, more effective therapies can be developed in the future to improve clinical outcomes of SAH.

Keywords: Delayed cerebral edema; Microclot; Microthrombosis; Subarachnoid hemorhage.

Publication types

Review

MeSH terms

Brain Ischemia* / drug therapy
Cerebral Infarction / complications
Cortical Spreading Depression* / physiology
Humans
Subarachnoid Hemorrhage* / therapy
Thrombosis* / complications
Vasospasm, Intracranial* / complications