This book showcases an organized approach to the emergent identification, diagnosis and critical care of the major types of stroke. Information on the care of ischemic stroke, subarachnoid hemorrhage and intracerebral hemorrhage is concisely presented. The pathophysiology of stroke is described. The text recounts the methods and processes by which neurologists, neurosurgeons, emergency physicians, neuroradiologists and intensivists organize stroke care today. The basic scientific rationale and the clinical scientific data supporting these methods of care delivery are presented.

Klappentext

The manuscripts in this book were generated from a conference occurring at the University of Heidelberg in September 1996. These manuscripts have been reviewed and updated by the designated authors in late 1997 for publication in early 1998. Conferences occur for a variety of reasons. These include the need to exchange information where complex activities are undergoing reassessment or change. For the emergency and critical care man­ agement of stroke this is certainly the situation. Today, both the pri­ mary care and the neurologic physician must provide medical care in an environment where daily change in the knowledge base of: brain function, disease mechanism(s), therapeutic efficacy, and cost control are all occurring. In addition, patient advocacy has become increasingly complex because government, employers, insurers, health care providers as well as families all desire a voice in the phy­ sician relationship with the patient. Our conference subject was the organization of rapid care delivery and the development of a ration­ al basis for treatment of a previously untreatable disorder acute stroke. Thus, the obvious need for multiple open and free discus­ sions about priority setting and modification of current treatment plans. Clearly, the face to face opportunities provided by this first conference on Emergency Management And Critical Care Of Stroke (EMACCOS) are required when patient care issues are as complex as these. Neuroscience is new to the experience of active therapeutic inter­ vention.

Inhalt

Improving Early Referral and Emergency Care in Acute Stroke.- Referral Patterns in Clinical Trials.- Pathophysiology of Stroke.- Autonomic Changes in Acute Cerebrovascular Disorders.- Intracranial Pressure and Circulatory Management.- Imaging and the Early Evaluation of Stroke.- Modern Imaging Technology in the Assessment of Acute Ischemic Stroke.- Thrombolytic Therapy in Acute Ischemic Stroke.- Preventing Postischemic Injury during Reperfusion.- Mechanisms of Reversible Injury and Neuroprotection.- Combined Neuroprotection/Thrombolysis in Acute Stroke.- Medical Management of Elevated ICP.- Surgical Management of Elevated ICP and Monitoring.- Intracerebral Hemorrhage Progression.- Surgical Treatment of Intracerebral Hemorrhage.- Operative and Interventional Neuroradiology.- Vasospasm Following Subarachnoid Hemorrhage: Medical and Transvascular Treatment.- Cytoprotective Drugs After Subarachnoid Hemorrhage.