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Prevention and Treatment of Delayed Ischaemic Dysfunction in Patients with Subarachnoid Haemorrhage - An Update (Paperback, Softcover reprint of the original 1st ed. 1988)
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Prevention and Treatment of Delayed Ischaemic Dysfunction in Patients with Subarachnoid Haemorrhage - An Update (Paperback, Softcover reprint of the original 1st ed. 1988)
Series: Acta Neurochirurgica Supplement, 45
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During the last meeting of the European Association of
Neurosurgical Societies (Barcelona 7-16 September 1987), a
Symposium was devoted to the use of calcium antagonists in cerebral
vasospasm. As shown by its title "Prevention and treatment of
delayed ischaemic dysfunction in patients with subarachnoid
haemorrhage: an update," papers presented at the Symposium covered
a broad spectrum from some basic data on pathophysiology of
subarachnoid haemorrhage (SAH) and delayed ischaemic dysfunction,
to the clinical use of nimodipine, which has been largely
documented among calcium inhibitors for its cerebrovascular
properties. This supplementum of Acta Neurochirurgica is based upon
the papers presented. Some articles, however, have been extended to
take into account further results in order to present a broad view
of the subject. The Symposium started with two presentations
concerning general aspects of SAH: in the first one, B. Voldby
reviewed the pathophysiological events following SAH: if
modifications of intracranial pressure (ICP) and decrease of
cerebral blood flow (CBF) are the primary alterations, metabolic
changes (particularly reduction in CMR0 ) 2 contribute rapidly to
disturbances of brain circulation. A variety of mechanisms may be
responsible for the neurological dysfunction: most of them are
directly related to the reduction in cerebral perfusion pressure
(CPP) which may result in ischaemia. This fall in CPP (either due
to elevation of ICP or reduction of mean arterial blood pressure)
is observed under different pathophysiological conditions,
discussed in the paper by A. D. Mendelow.
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