Efficacy and mechanisms of action of the cytoprotective lipid peroxidation inhibitor tirilazad mesylate in subarachnoid haemorrhage

E. D. Hall

Research output: Contribution to journalReview articlepeer-review

21 Scopus citations

Abstract

Subarachnoid haemorrhage (SAH) following cerebral aneurysm rupture or trauma can result in the induction of secondary ischaemic brain damage via a decrease in microvascular perfusion, a disruption of the bloodbrain barrier and consequent vasogenic oedema, and the delayed spasm of the major cerebral arteries (i.e. vasospasm). It is increasingly apparent that oxygen radical-induced, iron-catalyzed lipid peroxidation (LP) within the subarachnoid blood and vascular wall plays a key role in the occurrence of these secondary events. Tirilazad mesylate is a potent cytoprotective inhibitor of LP that works by a combination of radical scavenging and membrane stabilizing properties. It has been demonstrated to attenuate the acute and delayed vascular consequences of SAH and to protect the brain against ischaemic insults. Much of its action is mediated by an effect on the vascular endothelium, although it also appears to exert some direct neuroprotection and to inhibit LP in the subarachnoid blood. These actions of tirilazad in experimental SAH are reviewed.

Original languageEnglish
Pages (from-to)279-289
Number of pages11
JournalEuropean Journal of Anaesthesiology
Volume13
Issue number3
DOIs
StatePublished - May 1996

Keywords

  • Blood-brain barrier
  • Ischaemia
  • Lipid peroxidation
  • Subarachnoid haemorrhage
  • Tirilazad
  • Vasospasm

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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