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Neurovascular Network as Future Therapeutic Targets

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Cerebral Venous System in Acute and Chronic Brain Injuries

Part of the book series: Springer Series in Translational Stroke Research ((SSTSR))

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Abstract

In recent years, endovascular treatment, including pharmaceutical drugs and intervention therapy, has become one of the most effective strategies for stroke patients. However, neurobiological and neurovascular functions, before, during and after endovascular therapy, have not been fully addressed and remain to be clarified. It is extremely important for basic neurovascular scientists and clinicians to understand the neurobiological and neurovascular fundamentals of neuroimaging mismatches and the infarct size of stroke patients, hyperperfusion or hypoperfusion after thrombolysis or thrombolectomy, and brain swelling and hemorrhage after successful thrombolectomy. These clinical mismatches and complexities after endovascular therapy are related to active tissue connections in the neurovascular network and the function of neurobiological and neurovascular components after stroke. This comprehensive review summarizes the fundamental neurobiology and neurovascular function in endovascular therapy for stroke patients, using both basic science research and clinical studies, with a focus on cerebral hemodynamics, cell energy metabolism, and neurovascular injuries such as brain swelling, hemorrhage or over-reperfusion. A major emphasis is the potential role of cerebral collateral circulation and venous circulation during and after endovascular therapy. It is clear that the cerebral hemodynamic balance, venous function, and autoregulation are all involved in endovascular therapy.

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Abbreviations

CBF:

Cerebral blood flow

CBF:

Cerebral blood flow

CFI:

Collateral flow index

CO2:

Carbon dioxide

CPP:

Cerebral perfusion pressure

CT:

Computed tomography

CTA:

computed tomography angiography

CTP:

Computed tomography perfusion

CTV:

Computed tomography venography

DSA:

Digital subtraction angiography

DVP:

Draining vein pressure

DWI:

Diffusion weighted imaging

ECD:

Echo color Doppler

EG:

Emptying gradient

ET:

Emptying time

FG:

Filling gradient

FLAIR:

Fluid-attenuated inversion recovery

fMUS:

Functional micro-ultrasound

FT:

Filling time

GOS:

Glasgow outcome scale

HBinF:

Head inflow

HBoutF:

Head outflow

MCAO:

Middle cerebral artery occlusion

MRA:

Magnetic resonance angiography

MRI:

Magnetic resonance imaging

MRV:

Magnetic resonance venography

NIHSS:

National Institutes of Health Stroke Scale

NO:

Nitric oxide

OPS:

Orthogonal polarized spectral

PDGF:

Platelet-derived growth factor

PDGF-BB:

Platelet-derived growth factor-BB

PPARγ:

Peroxisome proliferator-activated receptor-gamma

rCBF:

Relative cerebral blood flow

rCBV:

Relative cerebral blood volume

ROS:

Reactive oxygen species

rtPA:

Recombinant tissue plasminogen activator

RV:

Residual volume

SPECT:

Single photon emission computed tomography

SSS:

Superior sagittal sinus

SWI:

Susceptibility weighted imaging

VEGF:

Vascular endothelial growth factor

VV:

Venous volume

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Acknowledgments

This work was supported by the National Institutes of Health (P01 NS082184, R01 NS081740, and R01 NS091042 to John H. Zhang), the National Basic Research Program of China (973 Program, 2014CB541600 to Hua Feng), the Major Technology Innovation Project of Southwest Hospital (SWH2016ZDCX1011 to Hua Feng) and the National Natural Science Foundation of China (81220108009 to Hua Feng, 81501002 to Yujie Chen).

Conflict of Interest

The authors declare that there are no conflicts of interest.

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Author notes

  1. Author contributed equally with all other contributors.Yujie Chen and Yang Zhang

Authors and Affiliations

  1. Department of Neurosurgery, Southwest Hospital, Third Military Medical University, Chongqing, China

    Yujie Chen & Hua Feng

  2. Departments of Anesthesiology, Neurosurgery, Neurology and Physiology, Neuroscience Research Center, Loma Linda University, Loma Linda, CA, USA

    Yujie Chen

  3. Department of Pediatrics, Loma Linda University, Loma Linda, CA, USA

    Yujie Chen, Andre Obenaus & Hua Feng

  4. Department of Laboratory Medicine, Southwest Hospital, Third Military Medical University, Chongqing, China

    Yang Zhang

  5. Department of Neurology, The First Hospital of Jilin University, Changchun, Jilin, China

    Zhenni Guo & Yi Yang

  6. Department of Neurology, The People’s Hospital of Nanpi County, Nanpi, Hebei, China

    Ling Liu

  7. Department of Interventional Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    Feng Gao

  8. Department of Interventional Neurology, The First People’s Hospital of Shijiazhuang City, Shijiazhuang, Hebei, China

    Yanfeng Lv

  9. Department of Neurology, Daping Hospital, Third Military Medical University, Chongqing, China

    Meng Zhang

  10. Department of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

    Xiaochuan Sun

  11. Department of Anesthesiology and Physiology, Loma Linda University, Loma Linda, CA, USA

    Jiping Tang & John H. Zhang

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  1. Yujie Chen
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Correspondence to Hua Feng .

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Editors and Affiliations

  1. Department of Neurology, The Second Affiliated Hospital of School of Medicine, Zhejiang University, Hangzhou, China

    Min Lou

  2. Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China

    Jianmin Zhang

  3. Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    Yilong Wang

  4. Department of Neurosurgery Tangdu Hospital, PLA Air Force Medical University, Xian, USA

    Yan Qu

  5. Department of Neurology, Medical University of South Carolina, Charleston, SC, USA

    Wuwei Feng

  6. Xuanwu Hospital Neurosurgery, Capital Medical University, Beijing, China

    Xunming Ji

  7. Department of Anesthesiology and Physiology, Loma Linda University, Loma Linda, CA, USA

    John H. Zhang

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Chen, Y. et al. (2019). Neurovascular Network as Future Therapeutic Targets. In: Lou, M., et al. Cerebral Venous System in Acute and Chronic Brain Injuries. Springer Series in Translational Stroke Research. Springer, Cham. https://doi.org/10.1007/978-3-319-96053-1_1

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