Damage Mechanism And Different Treatment Measures Of Spontaneous Intracerebral Hemorrhage

Spontaneous intracerebral hemorrhage(ICH)is a common type of fatal stroke,there is no effective way to improve their survival and quality of life.In order to further develop and explore new treatment measures,it is necessary to study the damage mechanism.Usually,the mechanism of injury after intracerebral hemorrhage is divided into primary and secondary damage.Among them,the primary damage occurs within minutes to hours from the onset of bleeding.During this stage,the rapid accumulation of blood within brain parenchyma leads to disruption of normal anatomy,the result of mechanical damage associated with the mass effect.Although the surrounding tissue compression and coagulation reaction to hemostatic,most of people will rebleeding within 24 hours,resulting in hematoma expand.When the bleeding site near the ventricle,the hematoma can break into the ventricle,causing intraventricular hemorrhage.At the secondary damage stage,blood coagulation and hematoma in brain parenchyma are progressively degraded,accompanied by a generation of thrombin and erythrocyte degradation products that trigger a series of inflammatory responses and complement activation.During the inflammation,a series of inflammatory mediators are locally produced or transported from other sites to the hemorrhage.These inflammatory cytokines and inflammatory mediators can activate resident microglia and astrocytes in the brain,and Infiltrating neutrophils,mast cells,lymphocytes,mononuclear cells in peripheral blood into hemorrhagic lesions,which further exacerbate the inflammatory reaction.Then it cause brain edema,blood-brain barrier damage,nerve excitotoxic injury.Ultimately,this pathogenesis leads to irreversible disruption of brain cell death and neurological function damaged.When a large number of nerve cells are damaged,it can cause brain atrophy.However,the brain also has its own defense mechanism.When subjected to bleeding stimulation,many protective factors increase.these protective factors can neutralize thrombin,hematoma degradation products of toxic effects.But these endogenous defense mechanisms can not completely resist the damage of bleeding.It is still needexogenous intervention and treatment.At present,there are a large number of experimental studies on intervention strategies for primary inflammatory damage,secondary inflammatory damage and endogenous defense mechanism.