Trauma of the Central Nervous System [antikvár]

Preface This volume of the Seminars in Neurological Surgery series presents recent research that has altered or enhanced our understanding of the epidemiology, path- ophysiologic mechanisms, and treatment of head and spinal cord injuries. Recent epidemiological studies highlight the importance of CNS trauma. Trauma ranks number three as a cause of death in America, and is the number one killer of those under 38 years of age. Brain injury accounts for about half of these deaths. Similarly, spinal cord injury affects a young population, causing severe disability at the time of greatest productivity. In the present volume the epidemiology of head injury is discussed as part of the larger trauma problem, and recent developments in head injury research centers funded by the National Institute for Neurological and Communicative Disorders and Stroke are described. The importance of ob- taining prospective data on the entire spectrum of head injury severity, and the degree and rate of recovery from neuropsychological, cognitive, and memory def- icits are stressed. This book presents recent data on mechanisms of brain and spinal cord injury and response to injury. The effect of CNS injury on the cerebral microcirculation is described in terms of blood flow control and maintenance of blood brain barrier function. At the cellular level, this volume describes axonal injury, the maintenance of systems controlling cation and extracellular metabolite concentrations, and the role of the neuronal injury response and scar formation in recovery of function. Selected aspects of new approaches to head injury therapy are reviewed. Several chapters discuss the importance of comprehensive trauma care systems, advanced life support in the field, and rapid evacuation of intracranial masses. Recent advances in the intensive care of head injured patients are described, with special emphasis on intracranial pressure control and nutritional support. The contributors to this volume stress the importance of applying basic techniques in neuroepidemiology and neuroscience to an understanding of the clinical problems encountered in head injured patients. It is our hope that through the application of this approach further progress in the prevention and treatment of brain and spinal cord injury can be achieved. This volume will be of interest to neurosurgeons, neurologists, traumatologists, and basic neuroscientists who have an interest in the problems of CNS trauma. Ralph G. Dacey, Jr. H. Richard Winn Rebecca W. Rimel John A. Jane