From bench to bedside: nanomedicine development for intracerebral hemorrhage - exploring microenvironment, innovation, and translation.

Intracerebral hemorrhage (ICH) carries a substantial global disease burden, and although it occurs less frequently than ischemic stroke, it results in a greater loss of disability-adjusted life years worldwide and is associated with one of the poorest prognoses among stroke patients. Due to the mechanisms of secondary injury following ICH, angiogenesis, inflammation, and oxidative stress (OS) levels in brain tissue are regulated by complex molecular pathways, leading to significant changes in the brain microenvironment (BME). While traditional treatments for ICH improve survival rates, they have notable drawbacks and limitations. Nanomedicines, as a promising approach, offer the potential to gradually overcome these limitations and are becoming increasingly important in ICH treatment research. This review provides an updated overview of the mechanisms behind the formation of the post-ICH BME, focusing on angiogenesis, inflammation, and OS. Conventional diagnostic and therapeutic methods are outlined, along with an analysis of their drawbacks and limitations. In addition, the current research status of nanomedicines targeting the post-ICH BME is systematically summarized from three perspectives: angiogenesis, inflammation, and OS. Finally, the progress of nanomedicines in clinical translation is analyzed, highlighting the challenges, opportunities, and future prospects for their application in the context of ICH.