Download e-book for kindle: Acute Aneurysm Surgery: Pathophysiology and Management by Keiji Sano M.D., D.M.Sc., F.A.C.S. (Hon.), Takao Asano M.D.,

By Keiji Sano M.D., D.M.Sc., F.A.C.S. (Hon.), Takao Asano M.D., D.M.Sc., Akira Tamura M.D., D.M.Sc. (auth.)

ISBN-10: 3709139848

ISBN-13: 9783709139844

ISBN-10: 3709139864

ISBN-13: 9783709139868

During fresh years, significant advances in surgical thoughts, diagnostic tools, anesthesia and adjunctive therapy within the care of sufferers with subarachnoid hemorrhage were accomplished. however, the general consequence of sufferers with SAH can't be considered as passable. the 1st a part of the e-book concentrates at the pathogenetic mechanisms underlying vasospasm and edema, the critical factors of negative final result. fresh growth within the box of membrane lipid metabolism has allowed the matter to be approached from a wholly new standpoint. the prospective participation of unfastened radicals, membrane lipids and eicosanoids is carefully mentioned. the second one half beneficial properties the issues of functional administration of SAH sufferers. Timing and indication of surgical procedure of aneurysms and the surgical strategies are defined in detail.

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Additional info for Acute Aneurysm Surgery: Pathophysiology and Management

Sample text

In cases dying later than 3 weeks, the above "acute" changes were replaced by the "late" changes of medial fibrosis and medial atrophy with an intimal thickening by subendothelial fibrosis, the latter causing a concentric narrowing of the arterial lumen. This "late" change, being identical to the previous finding of Conway and McDonald (1972), was remarkably similar to that of Heubner's arteritis (endoarteritis obliterans). The early changes were considered to be those of recent mural necrosis, while the late changes were regarded as repair phenomena.

This concept is in harmony with the early postischemic uncoupling wherein metabolism increases disproportionately to flow (Ginsberg et al. 1985). This line of thinking leads to an important clinical implication that cell damage caused by cerebral ischemia can possibly be minimized by specific antagonists to ex citatory amino acids (Wieloch et al. 1985, Rothman and Olney 1986). This therapeutic implication, however, may not directly be applied to clinical situations, because in either of SAH or cardiac arrest, the predominant brain pathology has been shown to be a diffuse, patchy cortical necrosis as described above.

1982c). III-2. Vasoconstriction induced by bloody CSF. No vasodilation occurred on addition of each antagonist (from Sasaki et al. 1984) C. Overview of the Basic Researches on the Pathogenesis of Vasospasm trials using ~-adrenergic stimulators, a-adrenergic blocking agents, catecholamine and/or serotonin depletors, phosphodiesterase inhibitors, nitrates, calcium antagonists, or many other drugs have invariably failed to prevent or reverse vasospasm (Wilkins 1980, Varsos et al. 1983, Grotenhuis et al.

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Acute Aneurysm Surgery: Pathophysiology and Management by Keiji Sano M.D., D.M.Sc., F.A.C.S. (Hon.), Takao Asano M.D., D.M.Sc., Akira Tamura M.D., D.M.Sc. (auth.)

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