Advances and Technical Standards in Neurosurgery by J. D. Pickard, N. Akalan, V. V. Dolenc, J. J. A. Mooij

By J. D. Pickard, N. Akalan, V. V. Dolenc, J. J. A. Mooij

This sequence, backed by way of the ecu organization of Neurosurgical Societies, has already develop into a vintage. generally, one quantity is released in line with 12 months. The Advances part provides fields of neurosurgery and similar components within which vital contemporary development has been made. The Technical criteria part positive aspects specified descriptions of normal methods to help younger neurosurgeons of their post-graduate education. The contributions are written via skilled clinicians and are reviewed by way of all participants of the Editorial Board.

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Marshall WH (1959) Spreading cortical depression of Lea˜o. Physiol Rev 39:239–279 6. Martins-Ferreira H, Nedergaard M, Nicholson C (2000) Perspectives on spreading depression. [Review] [124 refs]. Brain Res – Brain Res Rev 32:215–234 7. Gorji A (2001) Spreading depression: a review of the clinical relevance. Brain Res Rev 38:33–60 8. Obrenovitch TP, Zilkha E, Urenjak J (1996) Evidence against high extracellular glutamate promoting the elicitation of spreading depression by potassium. J Cereb Blood Flow Metab 16:923–931 9.

Depolarisation Phenomena in Traumatic and Ischaemic Brain Injury 39 5. Although cortical spreading depression and peri-infarct depolarisations have been extensively studied in the experimental in vivo models, there is now clear evidence that depolarisations also occur and propagate in the human brain in areas surrounding a focus of traumatic contusion. 6. Whether such events in the injured human brain represent cortical spreading depression or peri-infarct depolarisation is unclear. However, invasive and probably non-invasive monitoring methods are available which may serve to distinguish which event has occurred.

Arising from the original demonstration that loss of evoked potential amplitude could be reversed upon reperfusion, the initial concept of the ischaemic penumbra was of a ‘‘sleeping beauty’’ – a zone of cortex whose function was reversibly suppressed in a stable fashion, so that function could be restored at a much later time point by the magical touch of a vascular neurosurgeon carrying out an extra-intracranial vascular bypass procedure [96]. The study of PIDs and manipulations of their frequency has demonstrated instead that – without early reperfusion – the ischaemic penumbra is a maturation phenomenon in which the core infarct gradually Depolarisation Phenomena in Traumatic and Ischaemic Brain Injury 25 expands into penumbra, thus ‘‘recruiting’’ it.

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