Mechanisms of Secondary Brain Damage

This volume presents an interdisciplinary discussion on current knowledge of mechanisms of secondary brain damage evolving from cerebral trauma or ischemia. Contributions reach from the basic sciences to the daily clinical practice. Specific topics focus on functional analysis of the brain by NMR-spectroscopy or PET-scanning, as well as on quantitative histomorphological assessment of primary vs. secondary lesions in neurotraumatology. Other chapters are concerned with the acid-base regulation in cerebral ischemia, the current understanding of clinically relevant mediator compounds enhancing tissue damage in trauma or ischemia, in particular focusing on the amino acid glutamate. Valuable information is dealing with recent investigations on the recovery potential of the brain from ischemia in men, or the most modern treatment modalities of cerebral resuscitation after cardiac arrest, combining among others cardiopulmonary bypass, hemodilution, and hypothermia. Further highlights are discussion of the present state of prehospital emergency care, including logistics, training of personnel, and availability of specific trauma centers and, last but not least, evaluations of the clinical management of intracranial hypertension and brain tissue acidosis in several head injury.