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Brain Protection - Morphological, Pathophysiological and Clinical Aspects (Paperback, Softcover reprint of the original 1st ed. 1983)
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Brain Protection - Morphological, Pathophysiological and Clinical Aspects (Paperback, Softcover reprint of the original 1st ed. 1983)
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Significant progress has doubtlessly been made in the field of cere
bral protection compared to earlier centuries, as recently reviewed
by Elisabeth Frost (6). She cites the recommendations for treat
ment of brain trauma by Areteus, a Greek physician of the second
century A. D. He expressed quite modem views with regard to the
need for prompt action considering complications that follow even
minor symptoms. He advised burr holes for evacuation of hema toma
in seizures, the use of diuretics and, most interestingly, also
hypothermia. German surgeons of the 17th century had little more to
offer than prescriptions of which the most effective constituent
was alcohol (10). Thus, Sir Astley Cooper was probably the next
surgeon to make noteworthy contributions when advising the use of
leeches to the temporal artery and other means of bleeding in stead
of surgical intervention in cases of raised intracranial pressure
(loc. cit. 6). Although our knowledge has greatly expanded during
the last two decades, extensive discussions have led to only few
conclusions. Promising results from animal studies were translated
to clinical sit uations only to yield controversial and sometimes
confusing results. Since the observations of Brierly (5) on
ischemic cell damage, im proved information on structural aspects,
probably even related to concomitant biochemical studies, should
allow the validity of thera peutic concepts to be verified.
Investigations on cerebral ischemia have led to the differentiation
of synaptic transmission failure and membrane failure."
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