ZAK Zürich pp 160-172 | Cite as

Möglichkeiten zur Hirnprotektion

  • D. Heuser
  • H. Guggenberger
Conference paper
Part of the Anaesthesiologie und Intensivmedizin/Anaesthesiology and Intensive Care Medicine book series (A+I, volume 187)


Der Schutz des Gehirns vor den Folgen eines Mangels an Sauerstoff bzw. Substraten durch zeitlich begrenzte therapeutische Maßnahmen hat während der letzten Jahre im Rahmen anästhesiologischen bzw. intensivtherapeutischen Managements zunehmend an Bedeutung gewonnen.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Abbushi W, Herkt G, Speckner E, Birk M (1980) Beeinflussung des Hirndrucks bei Patienten mit Schädel-Hirn-Trauma durch PEEP-Beatmung und Oberkörperhochlagerung. Anaesthesist 29: 521–524PubMedGoogle Scholar
  2. 2.
    Aldrete JA, Romo-Salass R, Mazzin VDB, Tan SL (1981) Phenytoin for brain resuscitation after cardiac arrest: An uncontrolled clinical trial. Crit Care Med 6: 474–477CrossRefGoogle Scholar
  3. 3.
    Artru A A, Michenfelder JD (1981) Anoxic cerebral potassium accumulation reduced by phenytoin: Mechanism of cerebral protection? Anesth Analg 60: 41–45PubMedGoogle Scholar
  4. 4.
    Astrup J (1982) Energy — requiring cell functions in the ischemic brain. J Neurosurg 56: 482–497PubMedCrossRefGoogle Scholar
  5. 5.
    Astrup J, Symon L, Branston NM, Lassen NA (1977) Cortical evoked potential and extracellular K+ and H+ at critical levels of brain ischaemia. Stroke 8: 51–57PubMedCrossRefGoogle Scholar
  6. 6.
    Astrup J, Skovsted P, Gjerris F, Sørensen HR (1981) Increase in extracellular potassium in the brain during circulatory arrest: Effects of hypothermia, lidocaine, and thiopental. Anesthesiology 55: 256–262PubMedCrossRefGoogle Scholar
  7. 7.
    Aveldano MJ, Bezan NG (1975) Rapid production of diacylglycerols enriched in arachidonate and stearate during early brain ischemia. J Neurochem 25: 919–920PubMedCrossRefGoogle Scholar
  8. 8.
    Bedford RF, Persing JA, Pobereskin L, Butler A (1980) Lidocain or thiopental for rapid control of intracranial hypertension? Anesth Analg 59: 435–437PubMedGoogle Scholar
  9. 9.
    Cooper PR, Moody S, Clark WK, Kirkpatrick J, Maravilla K, Gould AL, Drane W (1979) Dexamethasone and severe head injury. J Neurosurg 51: 307–316PubMedCrossRefGoogle Scholar
  10. 10.
    Crane P, Swanson P (1970) Diphenylhydantoin and the cations and phosphates of electrically stimulated brain slices. Neurology (NY) 20: 1119–1123Google Scholar
  11. 11.
    Cullen JP, Aldrete JA, Jankovsky L, Romo-Salas F (1979) Protective action of phenytoin in cerebral ischemia. Anesth Analg 58: 165–169PubMedGoogle Scholar
  12. 12.
    Faupel G, Reulen HJ, Müller D, Schürmann K (1979) Dexamethason in severe head injuries. Neurosurg Rev 2: 105–111CrossRefGoogle Scholar
  13. 13.
    Fertziger AP, Liuzzi SE, Dunham PB (1971) Diphenylhydantoin: Stimulation of potassium influx in lobster axons. Brain Res 33: 592–596PubMedCrossRefGoogle Scholar
  14. 14.
    Ginsberg MD, Budd WW, Welsh FA (1978) Diffuse cerebral ischemia in the cat: I. Local blood flow during severe ischemia and recirculation. Ann Neurol 3: 482–492PubMedCrossRefGoogle Scholar
  15. 15.
    Guggiari M, Guillaume A, Dagreou F, Philippon J, Viars P (1983) Intracranial pressure (ICP) and hemodynamical effects of a new calcium blocking agent: Nimodipine. Anesthesiology 59: A357Google Scholar
  16. 16.
    Happel RD, Smith KP, Banik NL (1981) Ca++ accumulation in experimental spinal cord trauma. Brain Res 211: 476–479PubMedCrossRefGoogle Scholar
  17. 17.
    Harris RJ, Symon L, Branston NM, Bayhan M (1981) Changes in extracellular calcium activity in cerebral ischaemia. J Cereb Blood Flow Metab 1: 203–209PubMedCrossRefGoogle Scholar
  18. 18.
    Hass W (1981) Beyond cerebral blood flow, metabolism and ischemic thresholds: An examination of the role of Ca++ in the initiation of cerebral infarction. In: Medyer JS, Lechner H, Reivich M, Ott EO, Arabinar A (eds) Cerebral vascular disease, vol 3. Excerpta Medica, Amsterdam, pp 3–17Google Scholar
  19. 19.
    Heuser D (1982) Möglichkeiten und Grenzen cerebraler Protektion: Versuch einer Bestandsaufnahme. Anaesth Intensivmed 23: 315–324Google Scholar
  20. 20.
    Heuser D, Guggenberger H (1983) Recovery from disturbed cerebral ion homeostasis following severe incomplete ischemia and modification by the metabolic depressant drug etomidate. In: Wiedemann K, Hoyer S (eds) Brain protection. Springer, Berlin Heidelberg New York Tokyo, pp 38–44CrossRefGoogle Scholar
  21. 21.
    Heuser D, Morris PJ, McDowall DG (1981) Ionic changes in the brain with ischemia. In: Zindler M, Rügheimer E (eds) Anaesthesiology. Proc. 7th World Congress of Anaesthesiologists. Excerpta Medica, Amsterdam Oxford Princeton, pp 821–824Google Scholar
  22. 22.
    Hirsh LF (1980) Intra-arterial nitroprusside treatment of acute experimental vasospasm. Stroke 11: 601–605PubMedCrossRefGoogle Scholar
  23. 23.
    Hossmann KA (1982) Treatment of experimental cerebral ischemia. J Cereb Blood Flow Metab 2: 275–294PubMedCrossRefGoogle Scholar
  24. 24.
    Hossmann K-A, Lechtape-Grüter H, Hossmann V (1973) The role of cerebral blood flow for the recovery of the brain after prolonged ischemia. Z Neurol 204: 281–299PubMedCrossRefGoogle Scholar
  25. 25.
    Hossmann KA, Sakaki S, Zimmermann V (1977) Cation activities in reversible ischemia of the cat-brain. Stroke 8: 77–81PubMedCrossRefGoogle Scholar
  26. 26.
    Langfitt TW, Obrist WD (1981) Cerebral blood flow and metabolism after incranial trauma. In: Krayenbühl H, Maspes PE, Sweet WH (eds) Craniocerebral trauma, vol 10. Prog neurol Surg, pp 14–48. Karger, BaselGoogle Scholar
  27. 27.
    Levy WJ, Bay JW, Sawhny B, Tank T (1982) Aminophylline plus nitroprusside and dopamine for treatment of cerebral vasospasm. J Neurosurg 56: 646–649PubMedCrossRefGoogle Scholar
  28. 28.
    Ljunggren B, Schutz H, Siesjö BK (1974) Changes in energy state and acid — base parameters of the rat brain during complete compression ischemia. Brain Res 73: 277–289PubMedCrossRefGoogle Scholar
  29. 29.
    Lowry OH, Passonneau JV, Hasselberger FK (1964) Effect of ischemia on known substrates and co-factors of the glycolytic pathway in brain. J Biol Chem 239: 18–30PubMedGoogle Scholar
  30. 30.
    Lynch III C, Bedford RF (1983) Adverse effect of verapamil on ICP in patients with brain tumors. Anesthesiology 59: A392Google Scholar
  31. 31.
    Maekawa T, Oshibuchi T, Takeshita H, Imamura A (1981) Cerebral energy state and glycolytic metabolism during lidocaine infusion in the rat. Anesthesiology 54: 278–283PubMedCrossRefGoogle Scholar
  32. 32.
    Marshall WK, Page RB, Milchak MA (1982) Furosemide reduce brain water in cerebral injury in dogs. Anesthesiology [Suppl A308] 57: 3Google Scholar
  33. 33.
    Moncada S (1983) Biology and therapeutic potential of prostacyclin. Stroke 14: 157–168PubMedCrossRefGoogle Scholar
  34. 34.
    Moss E, Gibson JS, McDowall DG, Gibson RM (1983) Intensive management of severe head injuries. Anaesthesia 38: 214–225PubMedGoogle Scholar
  35. 35.
    Nemoto EM, Shiu GK, Bleyaert AL (1981) Efficacy of therapies and attenuation of brain free fatty acid liberation during global ischemia. Crit Care Med 9: 397–398PubMedCrossRefGoogle Scholar
  36. 36.
    Nemoto EM, Shiu GK, Nemmer JP, Bleyaert AL (1982) Attenuation of brain free fatty acid liberation during global ischemia: A model for screening potential therapies for efficacy? J Cereb Blood Flow Metab 2: 475–480PubMedCrossRefGoogle Scholar
  37. 37.
    Newberg LA, Michenfelder JD (1982) Cerebral protection by isoflurane during hypoxemia or ischemia. Anesthesiology 57: A335CrossRefGoogle Scholar
  38. 38.
    Pfenninger E, Kilian J, Ahnefeld FW, Lindner K (1983) Gerinnungsstörungen beim akuten Schädel-Hirn-Trauma. Anaesth Intensivther Notfallmed 18: 129–134CrossRefGoogle Scholar
  39. 39.
    Schanne FAX, Kane AB, Young EE, Farber J (1979) Calcium dependence of toxic cell death: A final common pathway. Science 206: 700–702PubMedCrossRefGoogle Scholar
  40. 40.
    Schulte am Esch J, Thiemig I, Entzian W (1980) Wirkungen von Etomidat und Thiopental auf den Stickoxydulbedingten intrakraniellen Druckanstieg. Anaesthesist 29: 525–529PubMedGoogle Scholar
  41. 41.
    Shiu GK, Nemoto EM (1981) Barbiturate dose — related attenuation of brain free fatty acid liberation during global ischemia. Anaesthesiology 55 [Suppl A2]Google Scholar
  42. 42.
    Shiu GK, Nemoto EM (1981) Barbiturate attenuation of brain free fatty acid liberation during global ischemia. J Neurochem 37: 1448–1456PubMedCrossRefGoogle Scholar
  43. 43.
    Shiu GK, Nemoto EM, Nemmer JP, Winter PM (1983) Comparative evaluation of barbiturate and Ca++ antagonist attenuation of brain free fatty acid liberation during global brain ischemia. In: Wiedemann K, Hoyer S (eds) Brain protection. Springer, Berlin Heidelberg New York Tokyo, pp 45–54CrossRefGoogle Scholar
  44. 44.
    Siesjö BK (1978) Brain energy metabolism. Wiley & Sons, Chichester New YorkGoogle Scholar
  45. 45.
    Siesjö BK (1981) Cell damage in the brain: A speculative synthesis. J Cereb Blood Flow Metab 1: 155–185PubMedCrossRefGoogle Scholar
  46. 46.
    Singbartl G, Cunitz G, Hamrouni H (1983) Die qualitative Wirkung der Beatmungstherapie/kontrollierten Hyperventilation beim zerebralen Trauma. Anaesthesist 32: 382–391PubMedGoogle Scholar
  47. 47.
    Steen PA, Newberg LA, Milde JH, Michenfelder JD (1983) Nimodipine improves cerebral blood flow and neurologic recovery after complete cerebral ischemia in the dog. J Cereb Blood Flow Metab 3: 38–43PubMedCrossRefGoogle Scholar
  48. 48.
    Strickartz G (1976) Molecular mechanisms of nerve block by local anesthetics. Anesthesiology 45: 421–441CrossRefGoogle Scholar
  49. 49.
    Todd MM, Toutant SM, Shapiro HM, Smith NT (1980) Intracranial pressure effects of low and high frequency ventilation. Anesthesiology 53: 196CrossRefGoogle Scholar
  50. 50.
    Volkman PH, Miletich DJ, Polk SL, Albrecht RF (1980) Treatment of subarachnoid hemorrhage — induced vasospasm: Increase in cerebral blood flow ( CBF) by the simultaneous infusion of angiotensin II and sodium nitroprusside. Anesthesiology 53: 192CrossRefGoogle Scholar
  51. 51.
    White BC, Gadzinski DS, Hochner PJ, Krome C, Hochner T, White JD, Trombley JH Jr (1982) Effect of flunarizine on canine cerebral cortical blood flow and vascular resistance post cardiac arrest. Ann Emerg Med 11: 119–126PubMedCrossRefGoogle Scholar
  52. 52.
    Young B, Rapp RP, Norton JA, Haack D, Tibbs PA, Bean JR (1983) Failure of prophylactically administered phenytoin to prevent early posttraumatic seizures. J Neurosurg 58: 231–235PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1986

Authors and Affiliations

  • D. Heuser
  • H. Guggenberger

There are no affiliations available

Personalised recommendations