脑出血:小血管疾病的急性表现?

IF 3.9 3区 医学 Q1 CLINICAL NEUROLOGY
Li-Li Tang, Yu-Jia Jin, Xue Qun Chen, Peiran Jiang, Feng Gao, Lu-Sha Tong
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引用次数: 0

摘要

虽然脑出血(ICH)和脑血管病(cSVD)长期以来被认为是不同的临床实体,但新出现的证据显示它们的病因和影像学标志物有显著的重叠。本文旨在探讨脑出血与cSVD之间的关系,提示脑出血可能是小血管疾病的急性表现。脑出血主要由脑淀粉样血管病和高血压引起,而cSVD主要由脑淀粉样血管病和小动脉硬化引起。高血压引起的小动脉硬化是心血管疾病最常见的病理改变之一。这种病因学上的重叠提示脑出血和心血管疾病之间的密切关系。在脑出血患者中,经常观察到cSVD的多种影像学标志物。最近的研究表明,血管周围空间的扩大,cSVD的影像学标志之一,可能是血肿扩张的途径。此外,在脑出血患者中经常观察到弥散加权成像病变。这些病变可能基于潜在的cSVD,并可能演变为其他cSVD标志物,如白质高信号、腔隙性梗死或微出血。这些发现强调了脑出血和cSVD之间复杂的相互作用,表明脑出血可能被认为是cSVD的急性表达,而不是一个完全独立的实体。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Intracerebral Hemorrhage: An Acute Manifestation of Small Vessel Disease?

Although intracerebral hemorrhage (ICH) and cerebral small vessel disease (cSVD) have long been considered distinct clinical entities, emerging evidence reveals significant overlap in their etiologies and imaging markers. This review aims to explore the relationship between ICH and cSVD, suggesting that ICH may represent an acute manifestation of small vessel disease. ICH is primarily caused by cerebral amyloid angiopathy and hypertension, while cSVD is mainly attributed to cerebral amyloid angiopathy and arteriolosclerosis. Hypertension-induced arteriolosclerosis is one of the most common pathologic changes in cSVD. This overlap in etiology suggests a close relationship between ICH and cSVD. In patients with ICH, multiple imaging markers of cSVD are often observed. Recent studies suggest that enlarged perivascular spaces, one of the imaging markers of cSVD, may serve as a pathway for hematoma expansion. Additionally, diffusion-weighted imaging lesions are frequently observed in patients with ICH. These lesions are likely to be based on underlying cSVD and may evolve into other cSVD markers, such as white matter hyperintensity, lacunar infarctions, or microbleeds. These findings highlight the complex interplay between ICH and cSVD, suggesting that ICH could be considered an acute expression of cSVD rather than an entirely separate entity.

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来源期刊
Neuroscientist
Neuroscientist 医学-临床神经学
CiteScore
11.50
自引率
0.00%
发文量
68
期刊介绍: Edited by Stephen G. Waxman, The Neuroscientist (NRO) reviews and evaluates the noteworthy advances and key trends in molecular, cellular, developmental, behavioral systems, and cognitive neuroscience in a unique disease-relevant format. Aimed at basic neuroscientists, neurologists, neurosurgeons, and psychiatrists in research, academic, and clinical settings, The Neuroscientist reviews and updates the most important new and emerging basic and clinical neuroscience research.
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