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Leukocytes, Macrophages and Secondary Brain Damage Following Cerebral Ischemia

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Mechanisms of Secondary Brain Damage in Cerebral Ischemia and Trauma

Part of the book series: Acta Neurochirurgica ((NEUROCHIRURGICA,volume 66))

Summary

The involvement of white blood cells in microvascular derangement as a cause of secondary brain damage following cerebral ischemia is reviewed. Relevant data from the literature are arranged in the chronological sequence of the microvascular derangement of the brain that occurs after cerebral arterial occlusion (as based on our own experimental observations). The inflammatory processes which appeared to be elicited by polymorphonuclear leukocytes (PMNL) in the ischemic region of the brain may begin with adhesion of PMNLs to endothelial cells, followed by blood-brain barrier disruption, transudation/exudation, edema, necrosis, and scar formation. Stimulated by cytokines released from damaged neurons and axons, two types of macrophages (ameboid and ramified) appear, increase in number in the ischemic lesion, and engulf the debris of dead neurons, degenerated axons. Further, macrophages may release cytokines which stimulate healing processes, such as astroglial proliferation and revascularization, and release neurotoxins which could gradually kill surviving neurons. Even under such circumstances, individual leukocytes/macrophages are well regulated by specific mediators/cytokines. An urgent task is thus to find ways of controlling these key mediators/cytokines to reduce the inflammatory process and the extent of neuronal death for attenuating the secondary brain damage, without altering their beneficial effects.

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Author information

Authors and Affiliations

  1. Department of Neurology, School of Medicine, Keio University, Shinanomachi, Shinjuku-ku, Tokyo, Japan

    Y. Fukuuchi

  2. Department of Neurology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160, Japan

    Minoru Tomita M.D.

Authors
  1. Minoru Tomita M.D.
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  2. Y. Fukuuchi
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Editors and Affiliations

  1. Institut für Chirurgische Forschung, Klinikum Grosshadern, Ludwig-Maximilians-Universität, München, Federal Republic of Germany

    Alexander Baethmann  & Nikolaus Plesnila  & 

  2. Institut für Neurochirurgische Pathophysiologie, Johannes-Gutenberg-Universität, Mainz, Federal Republic of Germany

    Oliver S. Kempski

  3. Klinik für Neurochirurgie, Universität zu Köln, Köln, Federal Republic of Germany

    Frank Staub

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© 1996 Springer-Verlag

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Tomita, M., Fukuuchi, Y. (1996). Leukocytes, Macrophages and Secondary Brain Damage Following Cerebral Ischemia. In: Baethmann, A., Kempski, O.S., Plesnila, N., Staub, F. (eds) Mechanisms of Secondary Brain Damage in Cerebral Ischemia and Trauma. Acta Neurochirurgica, vol 66. Springer, Vienna. https://doi.org/10.1007/978-3-7091-9465-2_6

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  • DOI: https://doi.org/10.1007/978-3-7091-9465-2_6

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-7091-9467-6

  • Online ISBN: 978-3-7091-9465-2

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