Mechanisms and interventions in aneurysmal subarachnoid hemorrhage: Unraveling the role of inflammatory responses and cell death in early brain injury (Review).

Abstract

Aneurysmal subarachnoid hemorrhage (aSAH) is a subtype of stroke associated with high morbidity and mortality rates worldwide, posing challenges in developing effective treatment strategies. The present review aimed to summarize the role of inflammation and pyroptosis in early brain injury (EBI), a key determinant of outcomes in aSAH, the interplay between oxidative stress, neuroinflammation and cell death and the immune‑inflammatory response and oxidative stress as central components in the pathogenesis of aSAH. Key signaling pathways include toll‑like receptor 4/NF‑κB and NLR family pyrin domain‑containing 3/gasdermin D pathways, which regulate inflammatory responses and pyroptotic cell death. Additionally, current and traditional Chinese therapeutic approaches to mitigating EBI and improving patient outcomes are summarized, demonstrating the potential roles of salvianolic acid B, pterostilbene, luteolin and electro‑acupuncture. The findings of the present review underscore the necessity for continued research into the molecular mechanisms underlying aSAH to translate these insights into clinical practice, enhancing patient survival and recovery.