The autoregulatory mechanism, including myogenic response, so-called "Bayliss effect", is well developed in the brain circulatory area, where also, cerebral vasospasm is often encountered after subarachnoid hemorrhage. In the cerebral artery smooth muscle, protein kinases, such as Rho-associated kinase, tyrosine kinase, and protein kinase C, are activated in response to mechanical stresses, including stretch, pressure and flow. All of these kinases are also activated in due course of time after development of the vasospasm. Myogenic response is a kind of reception and subsequent reaction to mechanical stress, whereas cerebral vasospasm is primarily caused by oxyhemoglobin, i.e., oxidative stress. Thus both myogenic and vasospastic episodes imply a common stress-responding mechanism. It seems possible that various kinases activated by mechanical stress act as not only a physiological signaling but also a proatherogenic/remodeling one. The stiffness of vasospastic artery was enormously increased in particular in the late phase of vasospasm, indicating the augmented process of pathologic remodeling. Therefore, "Bayliss effect" in modern sense and cerebral vasospasm can be argued in terms of a stress-reaction of cerebral artery.
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BMC Neurol
December 2024
Pharmacovigilance, Pharmacoepidemiology and Drug Information Centre, Department of Clinical Pharmacology, Rennes University Hospital, Rennes, 35033, France.
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December 2024
Department of Neurology, Albany Medical Center, Albany, NY, USA.
Intrathecal nicardipine (ITN) is an investigational therapy for cerebral vasospasm (CVS) and delayed cerebral ischemia (DCI) in patients with aneurysmal subarachnoid hemorrhage (aSAH). The objective of this scoping review was to characterize the current state of the literature and map the current available evidence, examine research methodology, clarify key concepts and definitions in the literature, report procedural characteristics, identify and analyze knowledge gaps, and serve as a precursor for future systematic reviews, meta-analyses, and randomized controlled trials. An electronic search for studies on ITN for the treatment of CVS and DCI in patients with aSAH was conducted in accordance with published standards.
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Department of Neurosurgery and Brain Repair, University of South Florida, Morsani College of Medicine, Tampa, FL, USA.
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Pak J Med Sci
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Prof. Dr. Abdul Majid, MBBS, FCPS, MCPS, Head Department of Neurosurgery, Department of Neurosurgery, Punjab Institute of Neurosciences, Lahore, Pakistan.
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Neurosurg Rev
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Neurosurgical Service, Beth Israel Deaconess Medical Center, Harvard Medical School, 110 Francis Street, Boston, MA, 02215, USA.
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