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Brain Edema XIV (Paperback, 2010 ed.)
Zbigniew Czernicki, Alexander Baethmann, Umeo Ito, Yoichi Katayama, Toshihiko Kuroiwa, …
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The XIV International Symposium on Brain Edema and Brain Tissue
Injury took place in Warsaw, Poland, on 11-14 June 2008. Two
prominent members of the International Society for Brain Edema: Dr.
Igor Klatzo and Dr. Julien Hoff have passed away after the last
2005 Symposium in Ann Arbor, USA. Dr. Igor Klatzo was actually the
founder of the Society, and the Advisory Board decided to
commemorate Dr. Igor Klatzo by introducing a lecture named after
him to be given at the Symposium. Prof. Dr. Hans-Jurgen Reulen has
been honored to give the frst Igor Klatzo lecture entitled "Bulk
Flow and Diffusion revisited, and Clinical Applications". This
volume contains 65 out of the 104 papers presented at the Symposium
as lectures or posters. The topics of the Symposium were similar to
those discussed at the previous ones. Many discussions focused on
clinical work especially diagnosis, subarachnoid hemorrhage,
hydrocephalus, and traumatic brain injury. Diagnosis and therapy,
including surgical methods, have also been verifed. Much attention
was drawn to the application of decompressive craniectomy in the
treatment of posttr- matic intracranial hypertension. The
pathomechanisms of brain edema and tissue injury studied in
experimental models have been also presented.
The first international symposium on brain edema was held in
Vienna/ Austria in 1965 followed by altogether eight meetings
since. The most recent was organized in Y okohama by the Department
of Neurosurgery of the Musashino Red Cross Hospital, Tokyo. The
continuing interest of both, clinicians and experimental scientists
alike may be attributable to the fact that brain edema is a common
denominator of many cerebral disorders, which under acute
conditions threatens life and weIl-being of afflicted patients.
Although progress in understanding as weIl as treatment can be
recognized since 1965 many problems remain, particularly concerning
the control of brain edema under acute conditions, as in trauma or
ischemia. A quantum leap was the distinction of the cytotoxic and
vasogenic brain edema prototypes as advanced by Igor Klatzo,
providing for transition from a morphological to functional
understanding now. The recent brain edema meetings were certainly
benefiting from developments of both, molecular neurobiology on the
one hand side and functional brain imaging at an ever-increasing
resolution on the other, such as magnetic resonance imaging
orpositron emission tomography. The international symposium in San
Diego 1996 may witness further breakthroughs, hopefully also of
effective treatment modalities. The symposium in Y okohama was
dedicated to the "Legacy of 28 Years of Brain Edema Research" as a
reminder of accomplishments as weIl as remaining challenges.
The Maturation Phenomenon, described by Ito et al. in 1975 [3) on
the basis of his to logical observations in the hippocampus as well
as other portions of the cerebral hemisphere, refers to the hours
or days of delay in the development of pathological changes in
various parameters of ischemic injury following the restoration of
blood flow to the ischemic brain. There is a direct relationship
between the intensity of ischemic insult and the speed and rate of
maturation of ischemic injury, a lesser intensity being associated
with slower and less severe development of the lesions. The delayed
neuronal death of CAl pyramidal cells of the hippocampus [8) is a
classic example. In the cerebral cortex, with increasing intensity
of the ischemic insult, the maturation phenomenon of ischemic
injuries intensifies, seamlessly, from less exten sive to more
extensive disseminated selective neuronal necrosis (DSNN), and then
further to cerebral infarction upon reaching a critical threshold
[1,2,4,6,7). We also have found that following ischemic insults
just under the threshold level required to induce infarction, only
disseminated selective neuronal necrosis (DSNN) progresses, while
following ischemic insults at the threshold level, initially only
DSNN develops, followed by the evolution of a gradually enlarging
infarcted focus [5, 7). The reporting of this phenomenon boosted
research in the field, as it became evi dent that ischemic damage
is not a sudden event, but a process potentially susceptible to
therapeutic intervention.
Many nerve cells of the brain which are not killed outright may
suffer delayed death or recovery after ischemic insult. This fact
has led to the concept of "maturation phenomenon" of neuronal
injuries. Since the 1st International Symposium on Maturation
Phenomenon in 1990, new developments, particularly in molecular
biology, have been rapidly bringing new information about molecular
nature and mechanisms of cell death. This book contains the
presentations of the 2nd International Symposium held in Tokyo in
April 1996. The latest developments in maturation phenomenon and
the present status of investigation are described and further
stimulation of research in this field is provided.
More than 60 papers written by internationally recognized experts
cover the broad spectrum of brain edema. The main topics treated
are: ischemia & hemorrhage, trauma (experimental and clinical),
cerebral hemorrhage, tumor, hydrocephlaus & intracranial
pressure (ICP), neuromonitoring & neuroimaging, treatments,
blood brain barrier, and miscellaneous.
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