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Current Neurovascular Research

Author(s): Zhen He*

DOI: 10.2174/1567202617666200415143201

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Pathogenic Mechanisms of a Stroke-like attack Elicited by Epidural Steroid Injection Therapy

Page: [312 - 318] Pages: 7

  • * (Excluding Mailing and Handling)

Abstract

Background: The pathogenic mechanisms involved in a disastrous scenario, following epidural steroid injections (ESI), remain unclarified. Intra-arterial injection of steroids with needlepenetrating vascular injury would be the culprit, as particulate medicine elicits a brain or spinal cord stroke-like attack.

Methods: On the other hand, the limited experimental approaches simulating an accidental steroid intra-arterial injection for ESI conflicted in their results: hemorrhage vs. ischemia.

Results: This article dissects the potential pathogenic mechanisms at a neurovascular unit. Noticeably, a schematic representation provides an explanation of how emboli formed by particulate steroids elicit either hemorrhagic, or ischemic lesion.

Conclusion: In addition, the development of a rat model with intravertebral artery steroid injection is a proposal to address the unmet need in evaluating steroids and vascular injury in ESI.

Keywords: Epidural steroid injections, stroke, living neurovascular unit, pathogenic mechanism, particulate steroids, spinal cord.

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