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The harmful effects of subarachnoid hemorrhage on extracerebral organs.

Chen S, Li Q, Wu H, Krafft PR, Wang Z, Zhang JH - Biomed Res Int (2014)

Bottom Line: Aside from secondary neurological injuries, SAH has been associated with nonneurologic medical complications, such as neurocardiogenic injury, neurogenic pulmonary edema, hyperglycemia, and electrolyte imbalance, of which cardiac and pulmonary complications are most common.Extracerebral complications are directly related to the severity of SAH-induced brain injury and indicate the clinical outcome in patients.We also aim to describe the manifestations, underlying mechanisms, and the effects of those extracerebral complications on outcome following SAH.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310009, China ; Department of Physiology and Pharmacology, Loma Linda University School of Medicine, Loma Linda, CA 92354, USA.

ABSTRACT
Subarachnoid hemorrhage (SAH) is a devastating neurological disorder. Patients with aneurysmal SAH develop secondary complications that are important causes of morbidity and mortality. Aside from secondary neurological injuries, SAH has been associated with nonneurologic medical complications, such as neurocardiogenic injury, neurogenic pulmonary edema, hyperglycemia, and electrolyte imbalance, of which cardiac and pulmonary complications are most common. The related mechanisms include activation of the sympathetic nervous system, release of catecholamines and other hormones, and inflammatory responses. Extracerebral complications are directly related to the severity of SAH-induced brain injury and indicate the clinical outcome in patients. This review provides an overview of the extracerebral complications after SAH. We also aim to describe the manifestations, underlying mechanisms, and the effects of those extracerebral complications on outcome following SAH.

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Schematic of nonneurologic medical complications following subarachnoid hemorrhage.
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fig1: Schematic of nonneurologic medical complications following subarachnoid hemorrhage.

Mentions: Aside from the primary and secondary neurological injury induced by this stroke subtype, SAH is also significantly associated with nonneurologic medical complications. Indeed, SAH patients are extremely vulnerable to multiple extracerebral organ dysfunctions (Figure 1). With improvements in the surgical and endovascular management of intracranial aneurysms, nonneurological complications will assume a more prominent role in the overall outcome of SAH patients [10], as such complications may increase the length of hospital stays as well as the need of intensive care unit management. Evidently, nonneurological organ dysfunctions correlate with the severity of brain injury following SAH. The most frequent nonneurologic medical complications occurring after SAH include pulmonary edema and pneumonia, cardiac arrhythmia, renal and hepatic dysfunction, electrolyte disturbance, and hematologic derangements [10]. Combinations of brain injury and extracerebral organ dysfunction may occur concurrently after SAH, and the latter may exacerbate brain injury during the acute phase of bleeding. Therefore, the prevention and management of nonneurological complications are important for improving the overall clinical outcome after SAH.


The harmful effects of subarachnoid hemorrhage on extracerebral organs.

Chen S, Li Q, Wu H, Krafft PR, Wang Z, Zhang JH - Biomed Res Int (2014)

Schematic of nonneurologic medical complications following subarachnoid hemorrhage.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4109109&req=5

fig1: Schematic of nonneurologic medical complications following subarachnoid hemorrhage.
Mentions: Aside from the primary and secondary neurological injury induced by this stroke subtype, SAH is also significantly associated with nonneurologic medical complications. Indeed, SAH patients are extremely vulnerable to multiple extracerebral organ dysfunctions (Figure 1). With improvements in the surgical and endovascular management of intracranial aneurysms, nonneurological complications will assume a more prominent role in the overall outcome of SAH patients [10], as such complications may increase the length of hospital stays as well as the need of intensive care unit management. Evidently, nonneurological organ dysfunctions correlate with the severity of brain injury following SAH. The most frequent nonneurologic medical complications occurring after SAH include pulmonary edema and pneumonia, cardiac arrhythmia, renal and hepatic dysfunction, electrolyte disturbance, and hematologic derangements [10]. Combinations of brain injury and extracerebral organ dysfunction may occur concurrently after SAH, and the latter may exacerbate brain injury during the acute phase of bleeding. Therefore, the prevention and management of nonneurological complications are important for improving the overall clinical outcome after SAH.

Bottom Line: Aside from secondary neurological injuries, SAH has been associated with nonneurologic medical complications, such as neurocardiogenic injury, neurogenic pulmonary edema, hyperglycemia, and electrolyte imbalance, of which cardiac and pulmonary complications are most common.Extracerebral complications are directly related to the severity of SAH-induced brain injury and indicate the clinical outcome in patients.We also aim to describe the manifestations, underlying mechanisms, and the effects of those extracerebral complications on outcome following SAH.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310009, China ; Department of Physiology and Pharmacology, Loma Linda University School of Medicine, Loma Linda, CA 92354, USA.

ABSTRACT
Subarachnoid hemorrhage (SAH) is a devastating neurological disorder. Patients with aneurysmal SAH develop secondary complications that are important causes of morbidity and mortality. Aside from secondary neurological injuries, SAH has been associated with nonneurologic medical complications, such as neurocardiogenic injury, neurogenic pulmonary edema, hyperglycemia, and electrolyte imbalance, of which cardiac and pulmonary complications are most common. The related mechanisms include activation of the sympathetic nervous system, release of catecholamines and other hormones, and inflammatory responses. Extracerebral complications are directly related to the severity of SAH-induced brain injury and indicate the clinical outcome in patients. This review provides an overview of the extracerebral complications after SAH. We also aim to describe the manifestations, underlying mechanisms, and the effects of those extracerebral complications on outcome following SAH.

Show MeSH
Related in: MedlinePlus