Current Progress in the Understanding of Secondary Brain Damage from Trauma and Ischemia: Proceedings of the 6th International Symposium: Mechanisms of Secondary Brain Damage-Novel Developments, Mauls/Sterzing, Italy, February 1998

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A. Baethmann, Nikolaus Plesnila, Florian Ringel, J. Eriskat
Springer Science & Business Media, Aug 19, 1999 - Medical - 120 pages
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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.
 

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Contents

A Key Mechanism Underlying Cell Damage?
1
Role and Mechanisms of Secondary Mitochondrial Failure
7
Initiating Mechanisms Involved in the Pathobiology of Traumatically Induced Axonal Injury and Interventions Targeted at Blunting Their Progression
15
Pro and AntiInflammatory Cytokines in the Injured Brain
21
Effects of Neurotrophins and Ciliary Neurotrophic Factor on Survival and Regeneration
31
Modelling of the Ischemic Penumbra
41
Topography Life Span and Therapeutic Response
45
Environmental Influence on Gene Expression and Recovery from Cerebral Ischemia
51
Assessment of Brain Tissue Viability Under Clinical Circumstances
73
HeparinMediated Extracorporeal LDLFibrinogen Precipitation HELP In Coronary and Cerebral Ischemia
81
What is Unique and Different
85
Apolipoprotein E and the Response of the Brain to Injury
89
System Analysis of Patient Management During the Pre and Early Clinical Phase in Severe Head Injury
93
The Frequency Antecedent Events and Causal Relationships of Neurologic Worsening Following Severe Head Injury
99
A Review
103
Challenges in Translating the Efficacy of Neuroprotective Agents in Experimental Models Into Knowledge of Clinical Benefits in Head Injured Patients
111

Neuroprotective Strategies in Nature Novel Clues for the Treatment of Stroke and Trauma
57
Glial Cell Swelling Effect of Hypothermia
63
The Clot Thickens Thrombolysis and Combination Therapies
67
Author Index
117
Index of Keywords
119
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