Neuroinflammation as a Target for Intervention in Subarachnoid Hemorrhage

Neuroinflammation as a Target for Intervention in Subarachnoid Hemorrhage
Author: Fernando Testai
Publisher: Frontiers Media SA
Total Pages: 88
Release: 2020-01-10
Genre:
ISBN: 2889633039

Aneurysmal subarachnoid hemorrhage (SAH) is a stroke subtype that affects, preponderantly, young adults. This condition carries a mortality of approximately 30-50% and a rate of permanent neurological disability of 30%. In addition, a substantial number of patients with an apparent good outcome suffer from residual neurocognitive impairment which, though subtle, prevents them from returning to work and having a normal life. Based on these data, it has been estimated that SAH is responsible for almost a quarter of all the years lost because of stroke. The calcium channel blocker nimodipine remains the only pharmacological treatment for SAH. This drug, however, has limited effectiveness and its use in clinical practice may be limited due to hypotension. Therefore, novel and effective treatments for this condition are desperately needed. The outcome in SAH has been associated with early brain injury, vasospasm, and delayed cerebral ischemia. Mechanistically, these processes are characterized by micro- and macro-vascular dysfunction, microthrombi formation, blood-brain barrier (BBB) dysregulation, brain edema, and neural-cell survival. Soon after SAH, there is a robust inflammatory response characterized by pyrexia, leukocytosis, and upregulation of adhesion molecules and cytokines in the periphery and in the CNS. Observational studies have shown that patients with more severe inflammatory responses experience worse outcomes after SAH. At the molecular level, different proinflammatory intracellular signaling pathways, including mitogen-activated protein-kinase and nuclear factor kappa-β, are activated in cerebral vessels after experimental SAH and their inhibition has been shown to decrease the occurrence of vasospasm. In addition, clinical and preclinical data have linked cytokine upregulation (interleukins [IL]-1B, IL-6 and IL-8, tumor necrosis factor-α, and monocyte chemoattractant protein-1), enhanced expression of adhesion molecules (selectins, integrins, and ICAM), and neutrophil activation to vasospasm of large cerebral arteries, microvascular dysregulation, and cell death. Moreover, immune cells regulate hemostasis and secrete active proteases, including matrix metalloproteinase 9, which promote microthrombosis and induce blood brain barrier dysfunction, respectively. In this context, it has been suggested that an enhanced inflammatory burden might contribute to brain injury in SAH through numerous downstream mechanisms. On the other hand, growing evidence demonstrates that neuroinflammation may influence the proliferation and migration of progenitor cells that participate of synaptic plasticity, neurogenesis, and neurorepair.

Miller's Anesthesia, 2-Volume Set E-Book

Miller's Anesthesia, 2-Volume Set E-Book
Author: Michael A. Gropper
Publisher: Elsevier Health Sciences
Total Pages: 3539
Release: 2024-07-18
Genre: Medical
ISBN: 0323936520

Offering up-to-date coverage of everything from historical and international perspectives to basic science and today's clinical practice, Miller's Anesthesia, 10th Edition, remains the #1 reference and trusted learning resource for practitioners and trainees in this complex field. Dr. Michael Gropper leads a team of expert editors and contributing authors who provide current information on the technical, scientific, and clinical issues you face each day—whether you're managing a challenging patient care situation, preparing for the boards, or studying for recertification. - Addresses timely topics alongside foundational basic science for an in-depth and comprehensive understanding of the field. - Contains thoroughly up-to-date content, including two new chapters: The Immune System: Implications for Anesthetic Management and Emergency Preparedness in Healthcare. - Provides new content in key areas such as sustainability, global health equity, the effect of anesthetics on immune function, anesthesia for special populations, coverage of infectious diseases including COVID-19, and occupational exposure and safety. - Offers state-of-the-art coverage of anesthetic drugs, guidelines for anesthetic practice and patient safety, new techniques, step-by-step instructions for patient management, the unique needs of pediatric patients, and much more—all highlighted by more than 1,200 full-color illustrations (300 new to this edition) for enhanced visual clarity. - Includes 40+ video clips demonstrating patient positioning, ultrasound, echocardiograms, and other imaging, and anesthetic procedures in real time.

Translational Research in Traumatic Brain Injury

Translational Research in Traumatic Brain Injury
Author: Daniel Laskowitz
Publisher: CRC Press
Total Pages: 388
Release: 2016-04-21
Genre: Medical
ISBN: 1498766579

Traumatic brain injury (TBI) remains a significant source of death and permanent disability, contributing to nearly one-third of all injury related deaths in the United States and exacting a profound personal and economic toll. Despite the increased resources that have recently been brought to bear to improve our understanding of TBI, the developme

Neurosonology in Critical Care

Neurosonology in Critical Care
Author: Camilo N. Rodríguez
Publisher: Springer Nature
Total Pages: 1143
Release: 2021-11-19
Genre: Medical
ISBN: 303081419X

This textbook addresses the classical use of Transcranial Doppler (TCD) and Transcranial Color-Coded Duplex Sonography (TCCS), focusing on the usefulness of neurological monitoring beyond classical acute brain injuries present in the daily intensive care medical practice. It encompasses a wide range of critical pathologies where neurological impact is part of clinical evolution, offering practical approaches for managing, application and interpretation of neurosonology to assist the physician to making real-time individualized decisions at bedside. It is an academic guide developed and edited by international experts being a very useful resource in daily practice for intensivists, neurologists, neurosurgeons and other specialists involving in critical care.

Neuroscience for Neurosurgeons

Neuroscience for Neurosurgeons
Author: Farhana Akter
Publisher: Cambridge University Press
Total Pages: 445
Release: 2023-12-31
Genre: Medical
ISBN: 110883146X

With advances in medicine and medical innovation, the face of neurosurgery has changed dramatically. A new era of surgeons values the need to undertake research in everyday practice and actively participate in the clinic and laboratory in order to improve patient prognosis. Highlighting the principles of basic neuroscience and its application to neurosurgical disease, this book breaks down neurological conditions into current academic themes and advances. The book is split into two sections, with the first covering basic and computational neuroscience including neuroanatomy, synaptic transmission and the growing use of artificial intelligence. The second section concentrates on specific conditions, such as gliomas, spinal tumors, and peripheral nerve injury. Outlining the clinical and pathophysiological principles of neurological conditions, this valuable book describes key animal models, helping clinicians design and conduct appropriate research projects to further knowledge and improve prognosis.

Timing of Aneurysm Surgery

Timing of Aneurysm Surgery
Author: L. M. Auer
Publisher: Walter de Gruyter GmbH & Co KG
Total Pages: 700
Release: 2019-05-20
Genre: Medical
ISBN: 3110858851

No detailed description available for "Timing of Aneurysm Surgery".

Neuroinflammation in Stroke

Neuroinflammation in Stroke
Author: Ulrich Dirnagl
Publisher: Springer Science & Business Media
Total Pages: 248
Release: 2013-04-17
Genre: Medical
ISBN: 3662054264

The successful treatment of acute stroke remains one of the major challenges in clinical medicine. Over the last decades, the understanding of stroke pathophysiology has greatly improved, while the therapeutic options in stroke therapy remain very limited. Today, hyperacute mechanisms of damage, such as excitotoxicity, can be discriminated from delayed ones, such as inflammation and apoptosis. Targeting of inflammation has already been successfully applied in various stroke models, but translation into a clinically efficacious strategy has not been achieved so far. In this book, leading experts in basic cerebrovascular research as well as stroke treatment review the current evidence for and against an important role for inflammation in stroke, and explore the potential of treating or modulating inflammation in stroke therapy.

Neurointensive Care Unit

Neurointensive Care Unit
Author: Sarah E. Nelson
Publisher: Springer Nature
Total Pages: 390
Release: 2020-03-18
Genre: Medical
ISBN: 3030365484

This book offers valuable guidance to neurointensivists, other neurocritical care staff, and those desiring to develop a neurocritical care unit via a thorough discussion of neurological emergencies and neurocritical care unit organization. This comprehensive volume begins with a review of acute neurological emergencies as managed clinically in the neurocritical care unit. Topics include acute cerebrovascular, neurological, and neurosurgical disorders. The unique aspect of this book is its description of the organization of the neurocritical care unit. We focus on how other services in the hospital interact with and assist neurocritical care operations, telemedicine/telestroke, and neurocritical care personnel and their roles. A review of expected outcomes of neurocritical care conditions is also included. Neurointensivists, neurocritical care unit staff leadership, hospital administrators, and those interested in developing a neurocritical care unit will find Neurointensive Care Unit: Clinical Practice and Organization to be an invaluable guide.

New Insight into Cerebrovascular Diseases

New Insight into Cerebrovascular Diseases
Author: Patricia Bozzetto Ambrosi
Publisher: BoD – Books on Demand
Total Pages: 358
Release: 2020-05-13
Genre: Medical
ISBN: 1789853591

“Brain circulation is a true road map that consists of large extended navigation territories and a number of unimagined and undiscovered routes.” Dr. Patricia Bozzetto Ambrosi This book combines an update on the review of cerebrovascular diseases in the form of textbook chapters, which has been carefully reviewed by Dr. Patricia Bozzetto Ambrosi, Drs. Rufai Ahmad and Auwal Abdullahi and Dr. Amit Agrawal, high-performance academic editors with extensive experience in neurodisciplines, including neurology, neurosurgery, neuroscience, and neuroradiology, covering the best standards of neurological practice involving basic and clinical aspects of cerebrovascular diseases. Each topic was carefully revised and prepared using smooth, structured vocabulary, plus superb graphics and scientific illustrations. In emphasizing the most common aspects of cerebrovascular diseases: stroke burden, pathophysiology, hemodynamics, diagnosis, management, repair, and healing, the book is comprehensive but concise and should become the standard reference guide for this neurological approach.