Information is provided from the basic and clinical sciences on the mechanisms damaging the brain from trauma or ischemia. New aspects involve the endoplasmic reticulum, mitochondrial failure, pathobiology of axonal injury, molecular signals activating glial elements, or the emerging therapeutical role of neurotrophins. Experimental issues involve a better analysis of the ischemic penumbra, the salvagable tissue. Therapeutic contributions reach from the environmental influence to gene expression, including neuroprotection, such as hibernation – mother nature’s experiment – or hypothermia which is reported to induce cell swelling. Treatment issues deal also with thrombolysis and combination therapies, or with the clearance of adverse blood components – LDL/fibrinogen – by a novel procedure using heparin. Other highlights are discussing the specificities of pediatric vs. adult brain trauma, or the evolving role of the Apolipoprotein-E e4 gene in severe head injury. An update is also provided on an online assessment of the patient management during the pre- and early hospital phase in Southern Bavaria. The empirical observation of neuroworsening is analyzed in further details, whether this is a specificity autonomously driving the posttraumatic course. Finally, the unsolved question why drug trials in severe head injury have failed so far in view of the promising evidence from the laboratory is subjected to an expert analysis.

In this first book to cover model systems, molecular mechanisms and clinical trials all in one volume internationally renowned scientists and clinicians provide a comprehensive treatment of neuroprotective strategies for all important neurological disorders. Following an overview of neurodegenerative, traumatic, and ischemic disorders, the book goes on to cover in vitro and animal model systems as well as cellular and molecular mechanisms. An extremely helpful analysis of clinical studies explains reasons for their success and failure, and the whole is rounded off with a look at the current challenges and hopes for the development of effective treatment strategies in the future.

Top level clinical and laboratory scientists present their most recent clinical and experimental findings and concepts. The well balanced contributions illustrate the enormous significance of the dialogue between both laboratory and clinic, ultimately for the benefit of the patients, and contribute to a better understanding of secondary brain damage from trauma and ischemia as basis to develop more effective treatment including drugs.

Neurotrauma: A Comprehensive Textbook on Traumatic Brain Injury and Spinal Cord Injury aims to bring together the latest clinical practice and research in the field of two forms of trauma to the central nervous system: namely traumatic brain injury (TBI) and spinal cord injury (SCI). This volume details the latest research and clinical practice in the treatment of neurotrauma, in a comprehensive but easy-to-follow format. Neurotrauma is a valuable resource for any clinician involved in caring for the TBI, clinical research professionals, researchers, medical and graduate students, and nurse specialists.

Brain edema is found in a wide variety of clinical disorders including stroke, intracerebral haemorrhage, subarachnoid haemorrhage, head injury, brain tumors and hydrocephalus. This volume brings together clinical and basic scientists from all over the world. Their expertise in the understanding of brain edema and shifts in brain water compartments has led to a further significant step in our understanding of those diseases characterized by brain edema. This book has also drawn on the expertise of the International Advisory Board of the Brain Edema Society, who have carefully summarized each section, thus providing an easy-to-read summary of the latest advances in each subject. The book is therefore much more than a collection of papers: it represents a critical appraisal and puts each paper into modern scientific context. The greatest advances have come from the rapid development of modern imaging techniques, especially with magnetic resonance imaging (MRI). Imaging can now produce "water maps” and "metabolic profiles” that bring brain metabolism and water content right into every clinic with access to MRI. This book provides the background knowledge to understand these pathophysiological changes.

Cerebral vasospasm remains a major clinical problem in patients with subarachnoid hemorrhage. Neuroprotection with calcium antagonists, hemodynamic therapy and interventional angioplasty have an established role in the management of this disease, but an effective single drug for prevention or treatment of the vasospasm is still lacking. This book contains selected contributions to the 7th International Conference on Cerebral Vasospasm held in Interlaken, Switzerland, in June 2000. Part I of the book concentrates on basic science and experimental vasospasm. The molecular biology of vasospasm, the role of endothelin and nitric oxide as well as the potential of gene therapy are presented. Part II concentrates on the diagnosis and therapy of clinical vasospasm. New diagnostic tools are presented, including diffusion and perfusion-weighted MRI, MR spectroscopy and microdialysis with metabolic monitoring. Leaders in the field discuss the current indications and results of endovascular treatment of cerebral vasospasm. The latter chapters are devoted to the treatment of clinical vasospasm with new drugs and to the prevention and treatment of ischemic deficits with neuroprotective drugs and hemodynamic therapy. The book provides the state-of-the-art in the major subjects of the molecular biology of vasoconstriction and experimental vasospasm as well as the diagnosis and treatment of clinical vasospasm.

Written for graduate students and trainees in mental health, this is the only text to present neurobiology in the context of clinical issues rather than merely focusing on experimental approaches to biological psychology or structuring it along neurological systems. In clear, easily accessible language the text explains how the brain and nervous system are linked to mental disorders. It integrates information from many aspects of neurobiological research, including imaging, neuropsychology, and genetics in order to foster an in-depth understanding of the psychiatric presentation of disorders that mental health professionals encounter in their practices. To facilitate student learning and clarify the connection between neurobiological foundations and clinical presentation, the text includes case studies, cognitive data, imaging results, genetic testing results, and illustrations. It examines major psychological disorders from behavioral, emotional, biological, cognitive and neurophysiological perspectives as they relate to brain structure and the major systems. Special topic sections highlight ethical, research, and treatment concerns for mental health practitioners. Each chapter concludes with summations and review questions. Written for graduate level students in clinical, counseling, and school psychology programs, the text fulfills APA accreditation requirements for coursework in the biological bases of behavior. While the textís primary aim is to help students understand neurobiological information as an important component of a therapeutic framework, it also concisely addresses micro and macro anatomy as relates to neurobiology. Also included are such supplementary teaching materials as test questions and PowerPoint slides of illustrations. Key Features: Focuses on the connection between neurobiology and clinical presentation Presents complex information clearly and concisely Highlights special topics in neurobiology ethics, research, and treatment Integrates information from imaging, neuropsychology, and genetics testing Prepares graduate students in clinical, counseling, and school psychology for professional practice

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.

Vols. for 1963- include as pt. 2 of the Jan. issue: Medical subject headings.