Pharmacological Preventions of Brain Injury Following Experimental Germinal Matrix Hemorrhage: an Up-to-Date Review
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REVIEW ARTICLE
Pharmacological Preventions of Brain Injury Following Experimental Germinal Matrix Hemorrhage: an Up-to-Date Review Jun Tang 1 & Yihao Tao 1 & Bing Jiang 1 & Qianwei Chen 1 & Feng Hua 1 & John Zhang 2 & Gang Zhu 1 & Zhi Chen 1
Received: 6 September 2015 / Revised: 24 October 2015 / Accepted: 2 November 2015 # Springer Science+Business Media New York 2015
Abstract Germinal matrix hemorrhage (GMH) is defined as the rupture of immature blood vessels in the subependymal zone of premature infants with significant mortality and morbidity. Considering the notable social and ecological stress brought by GMH-induced brain injury and sequelae, safe and efficient pharmacological preventions are badly needed. Currently, several appropriate animal models are available to mimic the clinical outcomes of GMH in human patients. In the long run, hemorrhagic strokes are the research target. Previously, we found that minocycline was efficient to alleviate GMH-induced brain edema and posthemorrhagic hydrocephalus (PHH) in rats, which may be closely related to the activation of cannabinoid receptor 2 (CB2R). However, how the two molecules correlate and the underlined molecular pathway remain unknown. To extensively understand current experimental GMH treatment, this literature review critically evaluates existing therapeutic strategies, potential treatments, and potentially involved molecular mechanisms. Each strategy has its own advantages and disadvantages. Some of the mechanisms are still controversial, requiring an increasing number of animal experiments before the therapeutic strategy would be widely accepted.
* Gang Zhu [email protected] * Zhi Chen [email protected] 1
Department of Neurosurgery, Southwest Hospital, Third Military Medical University, No. 30, Gaotanyan Street, Chongqing 400038, People’s Republic of China
2
Department of Neurosurgery, School of Medicine, Loma Linda University, Loma Linda, CA, USA
Keywords Germinal matrix hemorrhage . Animal model . Therapeutic strategy . Posthemorrhagic hydrocephalus
Introduction Germinal matrix/intraventricular hemorrhage (GMH/IVH) results in the most common neurological disorder with sequelae, including posthemorrhagic hydrocephalus (PHH), cerebral palsy, and debilitating cognitive deficits [1, 2], in which severity and incidence are inversely related to gestational age and birth weight [3]. This disorder occurs approximately 3.5 times per 1000 live births, and the incidence of GMH/IVH is higher under very low birth weights (VLBW, birth weight
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