Cerebral Ischemia and Basic Mechanisms

In this volume, one of a series of monographs devoted to the problems of cerebral ischemia and related topics, we present the proceedings of an international conference on Cerebral Ischemia and Basic Mechanisms held in Bad Schachen/Lake Constance, Germany in June 1992. The enormous progress in research recently on the basic mechanisms associated with cerebral ischemia has provided greater insight into the pathophysiological mechanisms of reduced brain perfusion and decreased cerebral metabolism. The high technology instrumentation used to unravel the intricacies of cerebral blood flow and metabolism includes positron emission tomography and magnetic resonance imaging. A description of sophisticated neurophysiological techniques will give the reader insight into new models of reversible and irreversible tissue damage and changes at the molecular level have been described. The therapeutic approaches which have developed from this re­ search have been or will be used in clinical trials and will open new avenues in the treatment of stroke. The organizers of the meeting would like to thank the advisory board for its helpful suggestions and the Deutsche Forschungsgemeinschaft and other sponsors for their important support. Front Matter....Pages I-XIV The Window of Opportunity for the Treatment of Cerebral Ischaemia....Pages 1-5 Front Matter....Pages 7-7 Uncoupling of Flow and Metabolism in Early Ischemic Stroke....Pages 9-18 Recovery from Motor Stroke: Different Patterns of Functional Reorganisation in Individual Patients....Pages 19-27 Head Injuries: A Target for Neuroprotection....Pages 28-35 Changes in the Biophysical Environment of Water Following Focal Brain Ischemia in the Rat....Pages 36-48 Front Matter....Pages 49-49 Aspects of Acid-Base Homeostasis in Ischemia....Pages 51-57 Acidosis: A Marker for Penumbra or a Target for Treatment?....Pages 58-63 Astrocytic H + and Ca 2+ Changes: Implications for Ischemic Brain Injury....Pages 64-76 Anoxic Injury of Central Myelinated Axons: Nonsynaptic Ionic Mechanisms....Pages 77-90 In Vivo Nuclear Magnetic Resonance Observation of Cerebral Metabolism....Pages 91-102 Effects of Extracellular Acidosis on Glial Cell Intracellular pH: Evidence for a Glial Spatial H + -Buffering Mechanism?....Pages 103-110 Front Matter....Pages 111-111 Calcium Channel Blockers Prevent Delayed Cerebral Ischemia After Intracranial Aneurysmal Subarachnoid Hemorrhage....Pages 113-124 Monosialoganglioside GM 1 in Experimental Models of Stroke....Pages 125-129 What Are We Learning from Clinical Trials in Acute Cerebral Ischemia?....Pages 130-136 Threshold of Calcium Influx After Global and Focal Ischemia: Implications for the Window of Therapeutic Opportunity....Pages 137-146 Non-NMDA Glutamate Receptors in the Regulation of Neuronal Ca 2+ and Excitotoxicity....Pages 147-157 Phenylalkylamine Calcium Antagonists as Cerebroprotective Agents....Pages 158-170 Intracellular Messengers After Ischemia....Pages 171-179 Influence of NMDA Receptor Antagonists on Glycine Receptor Isoform Expression in Spinal Cord Cultures....Pages 180-189 Effects of Calcium Antagonists on Experimentally Induced Carotid Intimal Proliferations....Pages 190-197 Front Matter....Pages 199-199 Unsettled Role of Glutamate/Glutamate Receptors in Ischemic Excitotoxic Neuronal Damage....Pages 201-203 Neuroprotective Effects of 5-HT 1A Receptor Agonists....Pages 204-216 In Vitro Ischemia in the Hippocampal Slice....Pages 217-229 Glial Swelling and Damage by Arachidonic Acid....Pages 230-234 Front Matter....Pages 235-235 Disturbances of Cerebral Protein Synthesis in Global and Focal Ischemia....Pages 237-249 Neurotrophin Expression and Gene Regulation in a Focal Cerebral Ischemia Model in the Rat....Pages 250-263 Nitroarginine Reduces Infarction After Middle Cerebral Artery Occlusion in Rats....Pages 264-272 No Appreciable Swelling of Cultured Neurons After Oxygen Deprivation, and Cell Damage Occasionally Aggravated by Oxygen Resupply....Pages 273-280 Front Matter....Pages 281-281 Changes in Gene Expression After Brief Ischemic Insults as Potential Mediators of Induced Tolerance: Postischemic Temperature as a Variable Affecting the Stress Response....Pages 283-291 Heat Shock Gene Expression as a Marker of Ischemic and Other Types of Injury....Pages 292-300 Gene Expression and Functional Changes After Acute Ischemia: Age-Related Differences in Outcome and Mechanisms....Pages 301-311 Models of Neural Circuit Reorganization After Injury....Pages 312-324 Clinical Relevance of Gene Expression in Cerebral Ischemia....Pages 325-328 Front Matter....Pages 329-329 Mechanisms of Leukocyte-Mediated No-Reflow and Tissue Injury in the Microcirculation....Pages 331-351 Microcirculatory Changes in Cerebral Ischemia....Pages 352-365 Current Evidence on a Pathophysiological Function of Leukocyte/Endothelial Interactions in Cerebral Ischemia....Pages 366-372 Do Leukocytes Contribute to the Brain Lesion That Begins When an Intracranial Artery Is Occluded?....Pages 373-380 Contribution of Neutrophils to Ischemic Brain Damage....Pages 381-390 Polymorphonuclear Leukocyte Adherence and Microvascular Reflow After Focal Cerebral Ischemia/Reperfusion....Pages 391-400 Activation of the Coagulation System and Concomitant Impairment of White Cell Rheology in Patients with Acute Cerebral Infarction....Pages 401-404 Front Matter....Pages 329-329 Microcirculatory Disturbance and Leukocytes: Influence of Leukocyte-Produced Superoxide on Red Blood Cell Aggregation....Pages 405-410 Small Volume Resuscitation in Hemorrhagic Shock by Hypertonic/Hyperoncontic Saline-Dextran: Effects on the Central Nervous System....Pages 411-420 Effects of Pentoxifylline on Recovery from Cerebral Ischemia and Reperfusion Injury....Pages 421-429 Regional Cerebral Blood Flow in Acute Stroke: Comparison of Two Calcium Antagonists....Pages 430-437 Back Matter....Pages 439-443 This documentation of an international conference on the underlying process of cerebral ischemia contains extensive reviews and new data on methodology and results of measurement of cerebral blood flow and cerebral metabolism in cerebral ischemia. Cellular processes involved in ischemiaof the brain are covered as well as new techniques for discovery of dynamic changes in acute ischemia of the brain. Therapeutic consequences are desribed with respect to their newest findings