Synopsis of the Round Table Discussion

Abstract

The round table discussion started with comments on the significance of ischemia and the maturation phenomenon in clinical practice: Prof. H.J. Reulen described clinical situations in which ischemia is induced during neurosurgical procedures or it results from an acute epidural or subdural hematoma. He expressed the hope that some day therapeutic, pharmacological “cocktails” may be effective in amelioration of these ischemic complications in neurosurgery. Prof. K. Takakura emphasized that in our research on ischemia we should focus our efforts on the ability of nervous tissue to recover or regenerate since this should be of direct benefit to the patients. Prof. K. Sano centered his comments on the problem of ischemia due to vasospasm, and he also expressed the hope that a successful treatment of vasospasm will be designed in the future. Prof. K. Hirakawa emphasized, on the basis of his clinical experiences with magnetic resonance spectroscopy and positron emission tomography, a great variability of metabolic states, depending on the time of observation and the nature of underlying causes, which makes application of efficient therapy a complex and difficult undertaking. Prof. M. Tomita outlined two main clinical types of stroke, one with sudden onset followed by a course toward recovery, the other showing a progression for days and weeks. He felt that in the latter type involvement of microcirculatory factors could constitute an important factor in protracted maturation of ischemic lesions