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New and groundbreaking therapeutic options for the critical care of patients with cerebrovascular disease have improved patient management, minimized morbidity, reduced in-patient care, improved quality of life, and had a positive economic impact on health service provision. This volume integrates these approaches and suggests the best therapy option for all cerebrovascular conditions. The early chapters of the book focus on monitoring techniques and interventions. Subsequent sections address the critical care of a wide range of cerebrovascular diseases: ischemic stroke, intracranial hemorrhage, subarachnoid hemorrhage, arteriovenous malformations, cerebral venous thrombosis and traumatic injury. The editors and authors are internationally recognized experts in their field, and the text is supplemented by tables and illustrations to demonstrate important clinical findings. This book will meet the needs of stroke physicians, neurologists, neurosurgeons, neurointensivists and interventional neuroradiologists seeking to maximize positive outcomes for their patients.

This open access book presents the diagnosis, investigation and treatment of neurovascular diseases, and offers expert opinions and advice on avoiding complications in neurovascular surgery. It also covers complication management and post-operative follow-up care. The book is divided in to three parts; the first part discusses common approaches in neurovascular surgery, describing the steps, indications for and limitations of the approach, as well as the associated complications and how to avoid them. The second part addresses surgical treatment based on pathology, taking the different locations of lesions into consideration. The third part focuses on the technological developments that support neurovascular surgery, which may not be available everywhere, but have been included to help vascular surgeon understand the principles. This book is a guide for young neurosurgeons, neurosurgery residents and neurosurgery fellows, as well as for medical students and nurses who are interested in neurosurgery or are associated with this field in any way. It is also a useful teaching aid for senior neurosurgeons.

The brain is the most complex organ in our body. Indeed, it is perhaps the most complex structure we have ever encountered in nature. Both structurally and functionally, there are many peculiarities that differentiate the brain from all other organs. The brain is our connection to the world around us and by governing nervous system and higher function, any disturbance induces severe neurological and psychiatric disorders that can have a devastating effect on quality of life. Our understanding of the physiology and biochemistry of the brain has improved dramatically in the last two decades. In particular, the critical role of cations, including magnesium, has become evident, even if incompletely understood at a mechanistic level. The exact role and regulation of magnesium, in particular, remains elusive, largely because intracellular levels are so difficult to routinely quantify. Nonetheless, the importance of magnesium to normal central nervous system activity is self-evident given the complicated homeostatic mechanisms that maintain the concentration of this cation within strict limits essential for normal physiology and metabolism. There is also considerable accumulating evidence to suggest alterations to some brain functions in both normal and pathological conditions may be linked to alterations in local magnesium concentration. This book, containing chapters written by some of the foremost experts in the field of magnesium research, brings together the latest in experimental and clinical magnesium research as it relates to the central nervous system. It offers a complete and updated view of magnesiums involvement in central nervous system function and in so doing, brings together two main pillars of contemporary neuroscience research, namely providing an explanation for the molecular mechanisms involved in brain function, and emphasizing the connections between the molecular changes and behavior. It is the untiring efforts of those magnesium researchers who have dedicated their lives to unraveling the mysteries of magnesiums role in biological systems that has inspired the collation of this volume of work.

This book focuses on subarachnoid hemorrhage (SAH), describing in detail the neurophysiology, anatomy, epidemiology, grading, anesthesia management, coiling and interventional treatment of this dangerous disease. Written by leading international experts, it highlights the state-of-the-art techniques for the diagnosis and treatment (non-surgical and surgical) of SAH and the clinical variations. It also examines the reliability of the new techniques versus the standard clinical methods to predict problems related to SAH and its recent diagnosis and management. The book starts with a brief discussion of the epidemiology of SAH, cerebral circulation, anatomy of brain blood vessels and neurophysiology related to this fatal disease. Then, in the following chapters it covers grading of subarachnoid hemorrhage, anesthesia management of SAH, treatment, subarachnoid hemorrhage coiling and radiological intervention. Lastly, it explores surgical treatment of intracranial aneurysms in more detail, and addresses complications, critical care management and headache in SAH, traumatic SAH and prognosis. Featuring numerous images, tables, schema, illustrations and videos, the book is intended for junior and senior anesthesiologists, neuroscientists, intervention radiologists, intensivists and neurosurgeons.

This e-book will review special features of the cerebral circulation and how they contribute to the physiology of the brain. It describes structural and functional properties of the cerebral circulation that are unique to the brain, an organ with high metabolic demands and the need for tight water and ion homeostasis. Autoregulation is pronounced in the brain, with myogenic, metabolic and neurogenic mechanisms contributing to maintain relatively constant blood flow during both increases and decreases in pressure. In addition, unlike peripheral organs where the majority of vascular resistance resides in small arteries and arterioles, large extracranial and intracranial arteries contribute significantly to vascular resistance in the brain. The prominent role of large arteries in cerebrovascular resistance helps maintain blood flow and protect downstream vessels during changes in perfusion pressure. The cerebral endothelium is also unique in that its barrier properties are in some way more like epithelium than endothelium in the periphery. The cerebral endothelium, known as the blood-brain barrier, has specialized tight junctions that do not allow ions to pass freely and has very low hydraulic conductivity and transcellular transport. This special configuration modifies Starling's forces in the brain microcirculation such that ions retained in the vascular lumen oppose water movement due to hydrostatic pressure. Tight water regulation is necessary in the brain because it has limited capacity for expansion within the skull. Increased intracranial pressure due to vasogenic edema can cause severe neurologic complications and death.

More than 40 articles provide an extensive coverage of clinical and basic science advances over the last three years of research on subarachnoid hemorrhage-induced brain injuries. Early brain injury, the new frontier of subarachnoid research, which may be a key contributor to the high mortality and morbidity, promotes collaborative efforts from neurosurgery, neurology, neuro-ICU into other interrelated fields and basic neurosciences. For the first time, subarachnoid hermorrhage research is almost equally divided by early brain injury and cerebral vasospasm, mechanistic investigations and therapeutic approaches, demonstrating a translational feature of the future direction.