Korean J Cerebrovasc Surg.
2003 Mar;5(1):17-30.
Pathophysiology of Aneurysmal Subarachnoid Hemorrhage
- Affiliations
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- 1Department of Neurosurgery, St. Vincent's Hospital, School of Medicine, The Catholic University of Korea, Suwon, Korea.
Abstract
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The effects of an intracranial aneurysm and subarachnoid hemorrhage (SAH) are devastating. Therefore thorough consideration for pathophysiology of SAH is fundamental step of vascular neurosurgeon. The cigarette smoking and hypertension are well-known risk factors of its growing and rupture. Medial defect and disruption of internal elastic lamina are prerequisite of initial budging of aneurysm formation. Many laboratory and simulatory experiments confirmed these pathologic and hemodynamic causes of aneurysm evolution. Some hydrodynamic studies contributed to understanding of commonly encountered various characteristics of aneurysm. After ictal bleeding, suddenly increased intracranial pressure elicit marked decrease of cerebral blood flow (CBF) and cerebral metabolic rate of oxygen (CMRO2) and these events decide on the grade of neurologic state. In case of SAH of young age, in is beneficial to rule out familial type. In this modern genetic engineering age, the significance of molecular and genetic approach of aneurysm is gathering strength.