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Hematoma Removal, Heme, and Heme Oxygenase Following Hemorrhagic Stroke
aMedical Research Service, Department of Veterans Affairs Medical Center, and Department of Neurology, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA bMedical Research Service, Department of Veterans Affairs Medical Center, White River Junction, Vermont, and Department of Medicine (Neurology), Dartmouth Medical School, Hanover, New Hampshire, USA
Address for correspondence: Kenneth R. Wagner, Ph.D., Research Service (151), Department of Veterans Affairs Medical Center, 3200 Vine Street, Cincinnati, OH 45220. Voice: 513-861-3100, ext. 4339; fax: 513-475-6415. wagnerkr{at}email.uc.edu Ann. N.Y. Acad. Sci. 1012: 237-251 (2004).
The hemorrhagic strokes, intracerebral (ICH) and subarachnoid hemorrhage (SAH), often have poor outcomes. Indeed, the most common hemorrhagic stroke, ICH, has the highest mortality and morbidity rates of any stroke subtype. In this report, we discuss the evidence for the staging of red blood cell removal after ICH and the significance of control of this process. The protective effects of clinically relevant metalloporphyrin heme oxygenase inhibitors in experimental models of ICH and in superficial siderosis are also discussed. We also examine literature paradoxes related to both heme and heme oxygenase in various disorders of the central nervous system. Last, new data are presented that support the concept that heme, although primarily a pro-oxidant, can also have antioxidant properties.
Key Words: brain hemorrhage • oxidative stress • heme • heme oxygenase • stroke This article has been cited by other articles:
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