Synopses & Reviews
This volume covers the most important aspects of cerebral blood flow (CBF) from bench to bedside. It first defines the basic physiology of CBF, those qualities that make it unique or are shared with other organs and their clinical implications. There follows a section on CBF pathophysiology that explores many of the known and proposed mechanisms of cerebral ischemia in stroke and trauma states. The third section describes the numerous and powerful means available to measure blood flow, tissue function and overall perfusion. These are essential measures if one is to assess the effectiveness of therapies aimed at preventing or reversing cerebral ischemia. The final section describes the interesting and often successful recent clinical trials aimed at preventing or reversing cerebral ischemia. This collection of multicenter trial data and their implications in one volume is unique in this field. This book addresses all the major aspects of CBF from basic issues to clinical practice.
Synopsis
Cerebral Blood Flow: Quantifying Consciousness Although the heart may be the source of energy needed to generate blood flow, and other organs absolutely essential for normal living, the brain is the reason we are alive. The collected book chapters are aimed at addressing this most fundamental organ and its blood flow. These papers reflect detailed descriptions of similar topics presented over a two-day period as part of the 5th International Symposium on Applied Physiology of the Peripheral Circulation held in Pittsburgh, Pennsylvania, in June 2000. The symposium and this volume were organized into four distinct groupings that follow in a logical fashion. The initial papers focus on the basic unique physiology and pathophysiology of the cerebral circulation, including a historical reviewof the means to measure cerebral blood flow and its implications of the past 30 years. Dr. Walter D. Obrist was one of the original investigators to use radiolabeled markers to assess cerebral blood flow. His equations and initial studies form an impressive introduction to where we are now. As with much of the body's special organs, the brain too has many circulatory features unique to itself.These include the unique blood-brain barrier function ofthe endothelium, local neural regulation control, and intracranial pressure effects. These special issues, plus genetic factors that may predispose individuals to developing cere- bral aneurysm, make up the initial section of the monograph.
Table of Contents
History of cerebral blood flow (CBF) assessment. Neural regulation of the cerebral circulation. Role of endothelium in regulation of the brain microcirculation. Molecular genetics of cerebral aneurysm. Triggering events in ischemic brain injury. Ischemic mechanisms in traumatic brain injury. Coupling and compartmentation of CBF and metabolism. The genetic control of ischemic neuronal cell death. Cerebral resuscitation from temporary complete global brain ischemia. The ischemic penumbra. The assessment of determinants of cerebral oxygenation and microcirculation. CT angiography and perfusion imaging of acute stroke. The use of Xenon/CT CBF studies in acute stroke. Advances in imaging in ischemic stroke. Assessment of cerebrovascular pathophysiology. CBF measurement with PET. Thrombolysis for acute stroke. Neuroprotective stroke trials. Interventional neuroradiology in acute ischemic stroke: extracranial and intracranial angioplasty and stenting. Therapeutic moderate hypothermia.