Overall Summary And Conclusions

As described in this review, experimental animal ICH models reproduce important pathophys-iologic events that develop in human ICH, including perihematomal edema, markedly reduced metabolism, and comparable brain tissue pathologic responses. Thus, these animal ICH models are important tools for new understanding of the mechanisms underlying brain injury after an intracerebral bleed. The recent publication from several laboratories describing ICH models in the mouse will enable new investigations into secondary inflammatory responses, intracel-lular signaling, and molecular events that are expected to provide future therapeutic targets for treating ICH. The continued use of a large noncompanion animal, such as the pig, enables studies of ICH-induced white-matter injury—an important contributor to patient morbidity. The large animal model also permits studies of surgical treatments that could be combined with pharmacologic approaches. A future animal model that would have considerable clinical applicability would be one that mimics the spontaneous enlarging hematoma with continued bleeding that is observed in about 30% of human ICH patients (121 ).

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