Primary and Secondary Brain Stem Lesions

This volume is the first to describe all clinically and experimental relevant aspects of primary and secondary brain stem lesions important to clinicians. It contains a detailed description of the computer-tomographical and morphological changes of the cerebral cisterns in acutely and chronically increased intracranial pressure. The prognostic value of clinical parameters of primary and secondary brain stem lesions is demonstrated. The possibilities of assessing the clinical course by computer-aided evaluation are presented. In addition to that, comprehensive view of morphological, radiological and clinical findings, extensive investigation concerning blink reflex (BR) and auditory evoked brain stem potentials (BAEP) supply highly relevant functional aspects of those lesions. The effects of raised intracranial pressure upon BR, BAEP as well as upon cerebral blood flow and focal flow in different brain areas were studied in animal experiments and reveal new and fascinating conclusions. Based on these investigations, a mathematical model following modern concepts of system analysis was developed. The model includes the intracranial system, autoregulation of cerebral flow (cardiovascular components) and the short-time behaviour of arterial blood pressure regulation.

Cerebral Mass Displacements. Part I: Cisternal Hernia in Intracranial Tumours in the Computer Tomogram.- Materials and Methods.- Results.- Influence of Tumour Location on Alterations of the Cisterns.- 1. Tumours of the Frontal Lobe.- 2. Tumours of the Temporal Lobe.- 3. Tumours of the Parietal Lobe.- 4. Tumours of the Occipital Lobe.- 5. Tumours of the Basal Ganglia.- 6. Tumours of the Posterior Cranial Fossa.- 7. Occlusive Hydrocephalus.- Discussion.- References.- Cerebral Mass Displacements. Part II: Clinical Findings in Primary and Secondary Brain Stem Lesions.- Patients and Methods.- Results.- 1. Individual Parameters and Their Combinations.- 2. Progress Investigations.- 3. Summary.- Discussion.- References.- Acute Direct and Indirect Lesions of the Brain Stem — CT Findings and Their Clinical Evaluation.- Summary.- Material and Methods.- Results.- 1. Supratentorial Lesions.- 2. Infratentorial Lesions.- 3. Direct Changes in the Brain Stem.- 4. Indirect Secondary Infarcts of the Brain Stem and Other Regions.- Discussion of the Indirect Secondary Infarcts.- References.- Electrically Elicited Blink Reflex and Early Acoustic Evoked Potentials in Circumscribed and Diffuse Brain Stem Lesions.- 1. Introduction and Objectives.- 2. Historical Review.- 3. Materials and Methods.- 4. Results.- 5. Summary.- References.- Blood Flow in Brain Structures During Increased ICP.- Summary.- Material and Methods.- 1. Blood Flow Measurement.- 2. Experimental Protocol.- Results.- 1. Control Values.- 2. Effect of ICP upon Systemic Measurements.- 3. Macroscopic Changes.- 4. rCBF in the Initial Phase of ICP Increase.- 5. Effect of ICP upon Regional CBF.- 6. Influence of ABP.- Discussion.- Acknowledgements.- References.- Biomathematics of Intracranial CSF and Haemodynamics. Simulation andAnalysis with the Aid of a Mathematical Model.- Summary.- Model Equations.- 1. Intracranial System.- 2. Cardiovascular Components.- 3. Baroreceptor Feedback Control.- 4. Disturbance of Central Regulation.- 5. Space Occupying Lesions.- Stability, Model Validation and Simulation Technique.- Model Applications.- 1. Intracranial Pulse Pressure Relationship and Haemodynamics.- 2. Volume Pressure Test and Haemodynamics.- 3. Parameter Estimation.- 4. Rhythmic Phenomena.- Discussion.- References.