Mechanisms of Secondary Brain Damage

1. Front Matter

   Pages I-VIII

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2. Brain Damage Studied by NMR and Other Methods

   1. NMR Spectroscopy: Current Status and Future Possibilities

      • David G. Gadian, S. R. Williams, T. E. Bates, R. A. Kauppinen

      Pages 1-8

   2. Cerebral Metabolic Studies in vivo by Combined ¹H/³¹P and ¹H/¹³C NMR Spectroscopic Methods

      • Kevin L. Behar

      Pages 9-20

   3. NMR-Spectroscopic Investigation of Cerebral Reanimation After Prolonged Ischemia

      • K.-A. Hossmann, K. L. Behar, D. L. Rothman

      Pages 21-29

   4. Magnetite as a Potent Contrast-Enhancing Agent in Magnetic Resonance Imaging to Visualize Blood-Brain Barrier Disruption

      • J. W. M. Bulte, M. W. A. de Jonge, R. L. Kamman, F. Zuiderveen, T. H. The, L. de Leij et al.

      Pages 30-34

   5. Absent Recruitment of Capillaries in Brain Tissue Recovering from Stroke

      • A. Gjedde, H. Kuwabara

      Pages 35-40

   6. Quantification of Primary and Secondary Lesions in Severe Head Injury

      • D. I. Graham, J. H. Adams, D. Doyle, I. Ford, T. A. Gennarelli, A. E. Lawrence et al.

      Pages 41-48

   7. Traumatic Damage to the Nodal Axolemma: an Early, Secondary Injury

      • T. A. Gennarelli, R. Tipperman, W. L. Maxwell, D. I. Graham, J. H. Adams, A. Irvine

      Pages 49-52

   8. Morphometrical Evaluation of Triflusal in Brain Infarction

      • N. Heye, A. Campos, S. Sampaolo, J. Cervos-Navarro

      Pages 53-55

3. Mediators and Antagonism in Secondary Brain Damage

   1. In vivo and in vitro Control of Acid-Base Regulation of Brain Cells During Ischemic and Selective Acidic Exposure

      • F. Plum

      Pages 57-63

   2. Mediators of Vascular and Parenchymal Mechanisms in Secondary Brain Damage

      • M. Wahl, L. Schilling, A. Unterberg, A. Baethmann

      Pages 64-72

   3. Glutamate Receptor Antagonists in Experimental Focal Cerebral Ischaemia

      • James McCulloch, E. Ozyurt, C. Kun Park, D. G. Nehls, G. M. Teasdale, D. I. Graham

      Pages 73-79

   4. Cerebral Protection by Adenosine

      • Peter Schubert, G. W. Kreutzberg

      Pages 80-88

   5. Effects of Acute Isotonic Saline Administration on Serum Osmolality, Serum Electrolytes, Brain Water Content and Intracranial Pressure

      • Hector E. James, S. Schneider

      Pages 89-93

   6. Ischemia as an Excitotoxic Lesion: Protection Against Hippocampal Nerve Cell Loss by Denervation

      • N. H. Diemer, F. F. Johansen, H. Benveniste, T. Bruhn, M. Berg, E. Valente et al.

      Pages 94-101

   7. Recovery of Brain Function Following Ischemia

      • Lindsay Symon

      Pages 102-109

   8. Systematic Development of Cerebral Resuscitation After Cardiac Arrest. Three Promising Treatments: Cardiopulmonary Bypass, Hypertensive Hemodilution, and Mild Hypothermia

      • P. Safar, F. Sterz, Y. Leonov, A. Radovsky, S. Tisherman, K. Oku

      Pages 110-121

4. Functional Consequences of Cerebral Lesions

   1. Taxonomy of Subjective Phenomena: a Neuropsychological Basis of Functional Assessment of Ischemic or Traumatic Brain Lesions

      • E. Pöppel

      Pages 123-129

   2. Blood Flow and Clinical Course in Patients with Ischemic Stroke without Cerebrospecifíc Therapy

      • A. Hartmann, C. Dettmers, H. Lagreze, Y. Tsuda

      Pages 130-135

5. Emergency Care and Treatment in Acute Cerebral Insults

   1. Assessment of Emergency Care in Trauma Patients

      • B. Bouillon, M. Schweins, A. Lechleuthner, M. Vorweg, H. Troidl

      Pages 137-140

Great progress has been made in the understanding and prevention of secondary brain damage from acute cerebral disorders, such as trauma and ischemia. Advances may be concerned in particular with better organization and logistics of preclinical emergency care, including rapid arrival of well-trained medical staff on the scene of an accident and of transportation to a competent hospital. Nevertheless, it is a safe assumption that development of secondary brain damage from both intra- and extracranial causes still represents a major factor for the final outcome in severe head injury. Thus, exchanges of experiences and information between various disciplines involved with this important clinical problem - trauma still assumes the number one position as a cause of morbidity and mortality up to an age of 45 years - may provide a basis for in-depth analysis of remaining problems as well as of methods of their solution. This exactly is the purpose of the present publication on concepts and findings pertinent for the general subject of secondary brain damage from various experimental as well as clinical viewpoints. An internationally high-ranking group of experts has been contributing to this collection of reviews on cerebral trauma and ischemia and its adverse sequelae, including cerebral exploration by most modern technologies, such as NMR spectroscopy or PET scanning, among others.

• Trauma
• brain
• care
• cerebral ischemia
• head
• head injury

• Institut für Chirurgische Forschung, Ludwig-Maximilians-Universität, Klinikum Grosshadern, München, Federal Republic of Germany

  Alexander Baethmann

• Institut für Neurochirurgische Pathophysiologie, Johannes-Gutenberg-Universität, Mainz, Federal Republic of Germany

  Oliver Kempski

• Neurochirurgische Klinik, Ludwig-Maximilians-Universität, Klinikum Grosshadern, München, Federal Republic of Germany

  Ludwig Schürer

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