Traumatic brain injury (TBI) remains a significant source of death and permanent disability, contributing to nearly one-third of all injury related deaths in the United States and exacting a profound personal and economic toll. Despite the increased resources that have recently been brought to bear to improve our understanding of TBI, the developme

This volume contains the most recent works on intracranial pressure and neuromonitoring in brain injury selected from 300 abstracts submitted to the 10th International Symposium on Intracranial Pressure. It includes state of the art monitoring of the brain injured patient in intensive care as well as the current state of knowledge in neurochemical and oxygen monitoring of the injured brain. Recent advances in molecular mechanisms of injury and the pathophysiology of ischemia and trauma are also included. "... this publication presents a comprehensive survey of the present state of art in the field and thus gives directions for further research to those engaged in ICP measurement and neuromonitoring”. Intensive Care Med

This volume contains the papers presented at the First International .ijm posium on Intracranial Pressure, held at the Neurosurgical Clinic of the Medizi nische Hochschule Hannover (Hannover Medical School), July 27 to 29, 1972. The texts submitted have been included in their original form whenever possible. The editors have made only minor corrections and rearrangements, since rapid publication was considered to be more important than homoge neity in style. The sessions of this book correspond to the sessions of the sym posium. At the end of each session the reader will find a summary of the topics presented and discussed, especially prepared by the chairman and co-chairman concerned. Three main aspects ofICP were dealt with at the Symposium: Methodology (Sessions 1 and 2), Pathophysiology (Sessions 3 to 6), and Clinical Aspects (Ses sions 7 to 10). Following the symposium a special round table was held on the major topics covered by the meeting. The participants of this round table discussed drafts prepared by T. W. LANGFITT, B. JENNETT and N. LUNDBERG. These contributions have also been included as special chapters at the end of this book, and are believed to reflect the current attitudes as to the topics discussed.

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.

This second edition presents core clinical neuroanesthesia and neurointensive care knowledge in a practical, user-friendly format.

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.