Therapeutic small molecules in the development of treatment for subarachnoid hemorrhage

Siddharth Shah, Abiy Tereda, Brandon Lucke-Wold, Pavel S. Pichardo-Rojas
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Abstract

Subarachnoid hemorrhage (SAH) is a severe and often fatal condition characterized by the accumulation of blood beneath the arachnoid layer of the meninges. Predominantly affecting individuals in the 40–60 age range, it is commonly caused by head trauma from falls or car accidents. Ruptures of cerebral aneurysms also contribute significantly to SAH. Risk factors for SAH include hypertension and smoking, and symptoms typically include severe headache and neck pain. Diagnosing SAH typically involves a combination of medical history, physical examination, and imaging studies such as computed tomography angiography or magnetic resonance imaging angiography. Recent research suggests that pharmaceutical management of intracerebral hemorrhage (ICH) includes the administration of recombinant activated factor VII, tranexamic acid, and aggressive blood pressure reduction. For patients with significant SAH and ICH, minimally invasive surgical procedures for hematoma evacuation, as well as surgical evacuation of SAH and ICH, have proven to be highly beneficial. Furthermore, an emerging area of treatment involves therapeutic small molecules designed to interrupt the pathophysiological pathways leading to SAH. This novel approach holds promise for advancing our understanding and management of this complex medical condition.
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开发治疗蛛网膜下腔出血的治疗性小分子药物
蛛网膜下腔出血(SAH)是一种严重且往往致命的疾病,其特点是血液积聚在脑膜的蛛网膜层下。它主要影响 40-60 岁年龄段的人,通常由跌倒或车祸造成的头部外伤引起。脑动脉瘤破裂也是导致 SAH 的重要原因。SAH 的危险因素包括高血压和吸烟,症状通常包括剧烈头痛和颈部疼痛。诊断 SAH 通常需要结合病史、体格检查和影像学检查,如计算机断层扫描血管造影术或磁共振成像血管造影术。最新研究表明,脑内出血(ICH)的药物治疗包括服用重组活化因子 VII、氨甲环酸和积极降压。对于严重 SAH 和 ICH 患者,微创手术血肿清除术以及 SAH 和 ICH 手术清除术已被证明非常有益。此外,一个新兴的治疗领域涉及旨在中断导致 SAH 的病理生理途径的治疗性小分子药物。这种新方法有望促进我们对这一复杂病症的理解和管理。
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