Table Of ContentBrain and Heart Infarct
Editors
K.1. Zi.ilch W. Kaufmann K.-A. Hossmann V. Hossmann
With Contributions by
N. Battistini R. M. Berne E. Betz R. J. Bing N. M. Branston Th. Colton
T. R. Dawber H. P. Diemer J. E. Doherty W. S. Fields C. Fieschi
R. Fischer J. C. Gautier M. D. Ginsberg J. Greenberg T. Hayakawa
W.-D. Heiss K.-A. Hossmann V. Hossmann D. H. Ingvar W.lsselhard
W. Kaufmann C. Kennedy H. G. Lasch R. D. Leachman W. Lochner
D. W. Lubbers Y Maruyama J. Moossy D. Morelot E. M. Nemoto
R. J. Nickerson c.-H. Nordstrom S. Passero M. Reivich W. C. Roberts
R. Rubio J. S. M. Sarma W. Schaper F. W. Schmahl H. Schmid-Schonbein
H. Shapiro B. K. Siesjo L. Sokoloff S. Strandgaard A. J. Strong L. Symon
O. Thulesius J. F. Toole F. Volante A. G. Waltz R. Weishaar J. Wich
mann R. W. Wissler Ph. A. Wolf B. Wusten K. J. Zulch
With 155 Figures
Springer-Verlag Berlin Heidelberg New York 1977
K.1. ZULCH, Professor Dr., Max-Planck-Institut fUr Himforschung, Abteilung fUr
Allgemeine Neurologie und Neurologische Klinik des Stiidtischen Krankenhauses
Kaln-Merheim, Ostmerheimer Str. 200, D-5000 Kaln 91 -Federal Republic of Germany
W. KAUFMANN, Professor Dr., Direktor der Medizinischen Klinik K61n-Merheim und
Poliklinik der Universitiit Kaln, 5000 Kaln 91-Federal Republic of Germany
K.-A. HOSSMANN, Professor Dr., Max-Planck-Institut fUr Hirnforschung, Abteilung fUr
Allgemeine Neurologie, Ostmerheimer Str. 200, D-5000 Kaln 91 - Federal Republic
of Germany
V. HOSSMANN, Dr., Medizinische Universitiits-Poliklinik Kaln-Lindenthal und
Medizinische Klinik Kaln-Merheim, Ostmerheimer Str. 200, D-5000 K61n 91 -
Federal Republic of Germany
ISBN-13: 978-3-642-66664-3 e-ISBN-13: 978-3-642-66662-9
DOl: 10.1007/978-3-642-66662-9
Library of Congress Cataloging in Publication Data. Main entry under title: Brain and heart infarct. Bibliography: p.
Includes index. I. Cerebrovascular disease-Congresses. 2. Heart··lnfarction-Congresses. I. Zulch, Klaus Joachim, 1910-.
II. Battistini, N. [DNLM: I. Cerebral embolism and thrombosis-Congresses. 2. Myocardial infarct··Congresses. W3 C1686L
1976b 1 WL355 C718 1976b] RC388.5.B7. 616.1'23. 77-8814.
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© by Springer-Verlag Berlin Heidelberg 1977
Softcover reprint of the hardcover 1s t edition 1977
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Preface
This symposium on cerebral and coronary vascular disorders and
infarcts is probably the first attempt to hold a joint discussion
in this field. Despite many difficulties we feel that it has been
successful and we hope that it will stimulate further interest
and investigations.
To hold such a meeting with scientists from far away was possible
only with the assistance of Bundesminister fUr Jugend, Familie
und Gesundheit, Minister fUr Hissenschaft und Forschung des Lan
des Nordrhein-Westfalen, Max-Planck-Gesellschaft zur Forderung
der Wissenschaften e.V., Deutsche Forschungsgemeinschaft, to whom
we are very grateful. Moreover the pharmaceutical industry gave
assistance in the organization and the transcript of the pro
ceedings.
Dr. G~TZE of Springer-Verlag, was, as we will explain later, the
original promotor of the idea for such a meeting. We should like
to thank Springer-verlag for the excellent layout and quality of
this book.
Koln, Spring 1977 K.J. ZULCH, W. KAUFMANN
K.-A. HOSSMANN, V. HOSSMANN
Contents
Welcome
K.J. ZULCH xv
Introduction
W. KAUFMANN ............................................... XIX
Coronary Circulation with Special Remarks on the Extra
vascular Component of Resistance and on Collateral Flow
W. LOCHNER, H. P. DIEMER, and J. WICHMANN. With 5 Figures ..
Vascular Reactivity and Ion Homeostasis in Heart and Brain
E. BETZ. With 7 Figures ................................... 10
Common Denominators in the Regulation of Blood Flow in
Heart and Brain
R. M. BERNE and R. RUBIO .................................. 19
Oxygen Transport in Heart and Brain
D. W. LUBBERS . . . . . . . . . . . . . . . . . . . . . . . . . • . . . . . . . . . . . . . . . . .. 30
Regulation of Brain Energy Metabolism under Normoxic and
Hypoxic Conditions
C.-H. NORDSTROM and B. K. SIESJO ................•..•...... 33
Biochemistry and Contractility of the Infarcted Heart
R. J. BING, J. S. M. SARMA, R. FISCHER, Y. MARUYAMA,
and R. WEISHAAR. With 13 Figures ......................... 41
Regional Metabolism of the Brain
M. REIVICH, L. SOKOLOFF, H.D. GINSBERG, C. KENNEDY,
H. SHAPIRO, and J. GREENBERG. With 10 Figures ......•..•... 58
Postischemic Amelioration of Brain Damage
E. M. NEMOTO. With 4 Figures ............................. 73
Coagulation Disturbances in Cerebrovascular Disorders
V. Hossmann. With 4 Figures .............................. 81
Coagulation Disturbances in Ischemic Heart Disease
F. W. SCHMAHL and H. G. LASCH . . . . . . . . . . . . . . . . . . . . . . . . . . .. 93
Rheological Properties of the Blood under Normal and
Pathological Conditions
H. SCHMID-SCHONBEIN. With 2 Figures ...................... 96
VIII
Total Ischemia of the Brain
K.-A. HOSSMANN. With 10 Figures ....................... ... 107
Experimental Ischemia: Total Ischemia of the Heart
(Metabolic Recovery form Complete Anaerobiosis)
W. ISSELHARD. With 7 Figures ............................. 125
Microflow and Unit Activity in the Cerebral Cortex
Following Ligation of the Middle Cerebral Artery
W.-D. HEISS, A.G. WALTZ, and T. HAYAKAWA. With 8 Figures 137
Gradation of Ischemia with Threshold Flow Levels for Tis
sue Function and Structure in the Brain
L. SYMON, N.M. BRANSTON, and A.J. STRONG. With 4 Figures 150
Experimental Ischemia: Heart Infarcts
B. WUSTEN and vJ. SCHAPER. With 3 Figures 159
Distribution of Cerebral Blood Flow at Rest und During
Mental Activation in Normals and in Patients with Brain
Disorders
D.H. INGVAR 167
The Heart in Hypertension
W. KAUFMANN. With 6 Figures 175
Hypertension and Cerebral Blood Flow
S. STRANDGAARD. With 3 Figures ........................... 185
Hypotension as a Risk Factor
O. THULESIUS. With 1 Figure .............................. 197
Cardiac Embolism and Arterial Hypertension as Risk Factors
of Cerebral Infarction
J . C. GAUTIER and D. MOR~LOT ..•........................... 201
Coronary Atherosclerosis and Ischemic Heart Disease
R.W. WISSLER. With 5 Figures ............................. 206
Risk Factors: Comparison of the Biological Data in Myo
cardial and Brain Infarctions
T.R. DAWBER, Ph.A. WOLF, Th. COLTON, and R.J. NICKERSON.
With 31 Figures ...............•.......................•.. 226
Cerebral Atherosclerosis: Morphology and Some Relationships
with Coronary Atherosclerosis
J. MOOSSY. With 1 Figure ................................. 253
Experimental Cerebral Ischemia by Arachidonic Acid-Induced
Platelet Emboli
C. FIESCHI, F. VOLANTE, N. BATTISTINI, and S. PASSERO.
~'Vith 6 Figures ...........•............................... 261
Transient Ischemic Events of the Heart-Angina Pectoris
R.D. LEACHMAN. With 8 Figures ............................ 271
IX
Transient Cerebral Ischemic Attacks (TIA'S)
W.S. FIELDS .............................................. 231
Clinical Ischemia: Brain Infarcts
K.J. ZULCH. With 6 Figures ............................... 288
Role of Thrombus in Causing Atherosclerosis and Fatal
Coronary Heart Disease
W. C. ROBERTS ........................................•.... 297
Therapy of Cerebrovascular Disorders
J. F. TOOLE . With 11 Figures .............................. 309
Therapy of Myocardial Infarction and Coronary Heart Disease
J. E. DOHERTY .........................................•... 323
General Discussion ...............•..•.................... 332
Subject Index ............................................ 345
List of Contributors
BATTISTINI, N., Clinica Malattie Nervose e Mentali del l'Uni
versita di Siena, I - Siena
BERNE, R.M., Department of Physiology, University of Virginia
Medical Center, Jordan Hall, P.O. Box 449, USA - Charlottes
ville, Virginia 22901
BETZ, E., Lehrstuhl I des Physiologischen Instituts, Gmelin
straBe 5, 0 - 7400 TUbingen 1
BING, R.J., University of Southern California, Huntington Memo
rial Hospital, 100 Congress Street, USA - Pasadena, CA 91105
BRANSTON, N.M., Institute of Neurology, University of London,
Queen Square, GB - London WC1N 3 BG
COLTON, Th., Dartmouth Medical School, USA - Hanover, New
Hampshire 03755
DAWBER, T.R., Boston University Medical Center, 80 E. Concord
Street, USA - Boston, Massachusetts 02118
DIEMER, H.P., Medizinische Einrichtungen der Universitat DUssel
dorf, Physiologisches Institut, MoorenstraBe 5, 0 - 4000
DUsseldorf 1
DOHERTY, J.E., University of Arkansas, College of Medicine,
Division of Cardiology, Veterans Administration Hospital,
USA - Little Rock, Arkansas
FIELDS, W.S., Department of Neurology, St. Anthony Center, 63
Almeda Road, USA - Houston, Texas, 77021
FIESCHI, C., Clinica Malattie Nervose e Mentali del l'Universita
di Siena, I - Siena
FISCHER, Renate, Research Scholar, University of Southern Cali
fornia, 100 Congress Street, USA - Pasadena, CA 91105
GAUTIER, J.C., C.H.U. pitie-Salpetriere, F - 75013 Paris
GINSBERG, M.D., Cerebrovascular Research Center, Hospital of the
University of Pennsylvania, Piersol Building, 3600 Spruce
Street, USA - Philadelphia, Pennsylvania 19104
XII
GREENBERG, J., Cerebrovascular Research Center, Hospital of the
University of Pennsylvania, Piersol Building, 3600 Spruce
Street, USA - Philadelphia, Pennsylvania 19104
HAYAKAWA, T., Department of Neurosurgery, Osaka University,
Osaka/Japan
HEISS, W.-D., Allgemeines Krankenhaus der Stadt Wien, Neurolo
gische Univ.-Klinik, Lazarettgasse 14, A - 1097 Wien
HOSSMANN, K.-A., Max-Planck-Institut fUr Hirnforschung, Ostmer
heimer StraBe 200, D - 5000 Kaln 91
HOSSMANN, V., Medizinische Klinik Kaln-Merheim, 6stmerheimer
StraBe 200, D - 5000 Kaln 91
INGVAR, D.H., Department of Clinical Neurophysiology, University
Hospital, S - 22185 Lund
ISSELHARD, W., Institut fUr Experimentelle Medizin der Universi
tat, Robert-Koch-StraBe 10, D - 5000 Kaln 41
KAUFMANN, W., Medizinische Universitats-Poliklinik und Medizini
sche Klinik Kaln-Merheim, Ostmerheimer StraBe 200, D - 5000
Kaln 91
KENNEDY, C., Laboratory of Cerebral Metabolism, National Insti
tutes of Mental Health, Building 36, USA - Bethesda, Mary
land, 20014
LASCH, H.G., Zentrum fUr Innere Medizin am Klinikum der Justus
Liebig-Universitat, KlinikstraBe 36, D - 6300 GieBen
LEACHMAN, R.D., 1717 Medical Towers Building, P.O. Box 20206,
USA - Houston, Texas 77025
LOCHNER, W., Medizinische Einrichtungen der Universitat, Physio
logisches Institut, MoorenstraBe 5, D - 4000 DUsseldorf 1
LUBBERS, D.W., Max-Planck-Institut fUr Systemphysiologie, Rhein
landdamm 201, D - 4600 Dortmund
MARUYAMA, Y., Research Scholar, University of Southern Califor
nia, 100 Congress Street, USA - Pasadena, CA 91105
MOOSSY, J., University of Pittsburgh, School of Medicine, Depart
ment of Pathology, USA - Pittsburgh, PA 15261
MORELOT, D., Service de Neurologie, Hopital Albert Chenevier,
F - 94, Creteil
NEMOTO, E.M., University of Pittsburgh, School of Medicine,
1060-C Scaife Hall, USA - Pittsburgh, PA 15261
NICKERSON, R.J., Harvard Medical School, 25 Shattuck Street,
USA - Boston, Massachusetts 02115
XIII
NORDSTROM, C.-H., Brain Research Laboratory, University Hospital,
S - 22185 Lund
PASSERO, S., Clinica Malattie Nervose e Mentali del l'Universita
di Siena, I - Siena
REIVICH, M., Cerebrovascular Research Center, Hospital of the
University of Pennsylvania, Piersol Building, 3600 Spruce
Street, USA - Philadelphia, Pennsylvania 19101
ROBERTS, W.C., National Institutes of Health, Claims Review Sec
tion OFM, USA - Bethesda, Maryland 20014
RUBIO, R., Department of Physiology, University of Virginia
Medical Center, Jordan Hall, P.O. Box 449, USA - Charlottes
ville, Virginia 22901
SARMA, J.S.M., University of Southern California, Huntington
Memorial Hospital, 100 Congress Street, USA - Pasadena, CA
91105
SCHAPER, W., W.G. Kerckhoff-Institut der Max-Planck-Gesellschaft,
Sprudelhof 11, 0 - 6350 Bad Nauheim
SCHMAHL, F.W., Zentrum fUr Innere Medizin der Justus Liebig-Uni
versitat, KlinikstraBe 36, 0 - 6300 GieBen
SCHMID-SCHONBEIN, H., Abteilung Physiologie der Rheinisch-West
falischen Technischen Hochschule Aachen, MelatenerstraBe 211,
o - 5100 Aachen
SHAPIRO, H., Anesthesiology Section, Veterans Administration
Hospital, 3350 LaJolla Village Drive, USA - San Diego, Cali
fornia, 92161
SIESJO, B.K., Brain Research Laboratory, University Hospital,
S - 22185 Lund
SOKOLOFF, L., Laboratory of Cerebral Metabolism, National In
stitutes of Mental Health, Building 36, USA - Bethesda, Mary
land 20014
f
STRANDGAARD, S., Medical Department, University Hospital of
Copenhagen, 9 Blegdamsvej, OK - 2100 Copenhagen
STRONG, A.J., Institute of Neurology, University of London,
Queen Square, GB - London WC1N 3BG
SYMON, L., Institute of Neurology, University of London, The
National Hospital, Queen Square, GB - London WC1N 3BG
THULESIUS, 0., Centrallasarettet Vaxjo, Kliniskt fysiologiska
laboratoriet, S - 35185 Vaxjo
TOOLE, J.F., Bowman Gray School of Medicine, USA - Winston
Salem, North Carolina 27103
