Thrombin and hemin as central factors in the mechanisms of intracerebral hemorrhage-induced secondary brain injury and as potential targets for intervention.


Journal Article (Review)

Intracerebral hemorrhage (ICH) is a subtype of stoke that may cause significant morbidity and mortality. Brain injury due to ICH initially occurs within the first few hours as a result of mass effect due to hematoma formation. However, there is increasing interest in the mechanisms of secondary brain injury as many patients continue to deteriorate clinically despite no signs of rehemorrhage or hematoma expansion. This continued insult after primary hemorrhage is believed to be mediated by the cytotoxic, excitotoxic, oxidative, and inflammatory effects of intraparenchymal blood. The main factors responsible for this injury are thrombin and erythrocyte contents such as hemoglobin. Therapies including thrombin inhibitors, N-methyl-D-aspartate antagonists, chelators to bind free iron, and antiinflammatory drugs are currently under investigation for reducing this secondary brain injury. This review will discuss the molecular mechanisms of brain injury as a result of intraparenchymal blood, potential targets for therapeutic intervention, and treatment strategies currently in development.

Full Text

Duke Authors

Cited Authors

  • Babu, R; Bagley, JH; Di, C; Friedman, AH; Adamson, C

Published Date

  • April 2012

Published In

Volume / Issue

  • 32 / 4

Start / End Page

  • E8 -

PubMed ID

  • 22463118

Pubmed Central ID

  • 22463118

Electronic International Standard Serial Number (EISSN)

  • 1092-0684

Digital Object Identifier (DOI)

  • 10.3171/2012.1.FOCUS11366


  • eng

Conference Location

  • United States