Brain Ischemia

By (author) Gusev, Eugene I.; By (author) Skvortsova, Veronika I.

This monograph highlights modern concepts of brain ischemia and strategies of neuroprotective therapy. The first part of the book is devoted to mechanisms of ischemic brain damage. The authors present the results of their own clinical and experimental studies conducted in the last two decades, as well as the achievements of native and foreign neurological researches that open a new stage in understanding how reversible changes of blood flow and metabolism are transformed into a permanent morphological lesion, i.e. brain infarction. The most important advances in areas of ischemic energy failure, main mechanisms of the glutamate-calcium cascade, influence of metabolic acidosis on ischemic damage, delayed neuronal death connected with microglial activation, local inflammation, autoimmune reactions, trophic dysfunction, and apoptosis, as well as of reaction of the stress-mediating endocrine system to focal brain ischemia are shown in animals and humans, and the relevant literature is cited and critiqued. The book also explores topics that recently have experienced substantial growth, such as gene expression and subsequent molecular events in response to acute brain ischemia, connected with both tissue damage and reparation. The authors demonstrate not only universal features of the process of brain ischemia, but also individual peculiarities of its course in patients and analyse their reasons.

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  • Introduction. Part I: Mechanisms of Ischemic Brain Damage. 1. Hemodynamic Events Associated with Acute Focal Brain Ischemia and Reperfusion. Ischemic Penumbra. 2. Cellular Reactions in Response to Acute Focal Brain Ischemia. 3. Energy Failure Induced by Brain Ischemia. 4. The Glutamate-Calcium Cascade. 4.1. The Induction Stage: Energy-Dependent Ion Pump Failure And Glutamate Excitotoxicity. 4.2. The amplification stage: intracellular accumulation of calcium ions, spreading glutamate release, spreading depression waves. 4.3. The expression stage: calcium-inducedactivation of intracellular enzymes, oxidative stress and abundant NO production, and accumulation of low molecular weight cytotoxic substances. 5. Metabolic Acidosis and Ischemic Damage. 6. Delayed Neuronal Death Following Acute Focal Brain Ischemia. 7. Gene Expression and Subsequent Molecular Events in Response to Acute Brain Ischemia. 8. Microglial Activation, Cytokine Production, and Local Inflammation in Focal Brain Ischemia. 8.1. Dynamics of pro-inflammatory and regulatory cytokines and C-reactive protein concentration in CSF of patients with acute ischemic stroke. 8.2. Microvascular-cellular cascade and secondary brain damage. 9. Autoimmune Mechanisms of Trophic Dysfunction and Ischemic Brain Damage. 9.1. Nerve growth factor (NGF) and its autoantibody concentration in CSF and serum of patients with ischemic stroke. 9.2. Neurospecific protein S100b and its autoantibody concentration in CSF and serum of patients with ischemic stroke. 9.3. Myelin basic protein and its autoantibody concentration in CSF and serum of patients with ischemic stroke. 9.4. Content of autoantibodies to NGF, S100beta, and MBP in serum of patients with chronic brain ischemia. 10. Programmed Cell Death. Apoptosis in Focal Brain Ischemia. 11. Reaction of the Stress-Mediating Endocrine System in Response to Acute Brain Ischemia. 12. Molecular Mechanisms of Post-Ischemic Reparation Events. Part II: Neuroprotection in Brain Ischemia. 13. Modern Therapeutic Approaches to Acute Focal Brain Ischemia. Basic Strategies for Neuroprotection. 14. Primary Neuroprotection. 14.1. Potential-dependent calcium channel antagonists. 14.2. Glutamate receptor antagonists. 14.3. Inhibitors of synthesis and pre-synaptic release of glutamate. 14.4. GABA agonists. 14.5. Glycine. 15. Secondary Neuroprotection. 15.1. Antioxidants. 15.2. Anti-intercellular adhesion molecule (anti-ICAM) antibodies. 15.3. Pro-inflammatory cytokine inhibitors
  • anti-inflammatory factors. 15.4. Statins and estrogens. 15.5. Neurotrophic factors. 15.6. Neuropeptides. 15.7. Gangliosides. 15.8. Prevention of apoptosis. 16. Reparative Therapy. 16.1. Piracetam. 16.2. Citicoline sodium. 16.3. Gliatilin. 16.4. Carnitine chloride. 17. Strategies and Prospects for Development of Neuro-protective Therapy for Brain Ischemia. Conclusion. Index.

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書名 Brain Ischemia
著作者等 Skvortsova, Veronika I.
Gusev, Eugene I.
出版元 Springer-Verlag New York Inc.
刊行年月 2012.10.13
版表示 Softcover reprint of the original 1st ed. 2003
ページ数 396p
大きさ H229 x W152
ISBN 9781461348573
言語 英語
出版国 アメリカ合衆国

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