Role of platelets in the pathogenesis of delayed injury after subarachnoid hemorrhage

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Role of platelets in the pathogenesis of delayed injury after subarachnoid hemorrhage

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Ari Dienel, Peeyush Kumar T, Spiros L Blackburn, ...

First Published June 10, 2021 Review Article 

https://doi.org/10.1177/0271678X211020865

Article information

Abstract

Aneurysmal subarachnoid hemorrhage (aSAH) patients develop delayed cerebral ischemia and delayed deficits (DCI) within 2 weeks of aneurysm rupture at a rate of approximately 30%. DCI is a major contributor to morbidity and mortality after SAH. The cause of DCI is multi-factorial with contributions from microthrombi, blood vessel constriction, inflammation, and cortical spreading depolarizations. Platelets play central roles in hemostasis, inflammation, and vascular function. Within this review, we examine the potential roles of platelets in microthrombi formation, large artery vasospasm, microvessel constriction, inflammation, and cortical spreading depolarization. Evidence from experimental and clinical studies is provided to support the role(s) of platelets in each pathophysiology which contributes to DCI. The review concludes with a suggestion for future therapeutic targets to prevent DCI after aSAH.

Keywords Subarachnoid hemorrhage, aneurysm, delayed deficits, delayed cerebral ischemia, platelets

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