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RESEARCH PRODUCT

Biochemical Factors and Mechanisms of Secondary Brain Damage in Cerebral Ischemia and Trauma

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A distinction between primary and secondary manifestations of brain damage from acute insults, such as trauma, or ischemia is not only of scientific interest but also of the highest clinical significance. After all, prevention of secondary brain damage in patients with severe head injury or cerebral ischemia is the ultimate purpose of treatment, including the measures of emergency care. It can be assumed that the secondary sequelae of head injury are as important for the outcome as the primary insult is. Therefore, it is obvious that development of more effective forms of treatment requires a better understanding of the mechanisms underlying secondary brain damage. Manifestations of secondary brain damage can be defined on a neuropathological or pathophysiological basis. They have a wide spectrum reaching from macroscopic phenomena, such as brain swelling, to subtle processes, such as cytotoxic cell damage from distinct molecular mechanisms. This chapter is a summary of recent concepts and findings.