Table Of ContentActa Neurochirurgica Supplement 121
Richard L. Applegate
Gang Chen
Hua Feng
John H. Zhang Editors
Brain Edema XVI
Translate Basic Science into Clinical Practice
Acta Neurochirurgica Supplement 121
Series Editor
H.-J. Steiger
For further volumes:
http://www.springer.com/series/4
Richard L. Applegate (cid:129) Gang Chen (cid:129) Hua Feng
John H. Zhang
Editors
Brain Edema XVI
Translate Basic Science into
Clinical Practice
Editors
Richard L. Applegate Hua Feng
Department of Anesthesiology Department of Neurosurgery
Loma Linda University School of Medicine Third Military Medical University Southwest
Loma Linda Hospital
California Chongqing
USA China
Gang Chen John H. Zhang
Department of Neurosurgery Departments of Anesthesiology
Soochow University The First Physiology and Neurosurgery
Affi liated Hospital Loma Linda University School of Medicine
Suzhou Loma Linda
Jiangsu California
China USA
ISSN 0065-1419
ISBN 978-3-319-18496-8 ISBN 978-3-319-18497-5 (eBook)
DOI 10.1007/978-3-319-18497-5
Library of Congress Control Number: 2015949156
Springer Cham Heidelberg NewYork Dordrecht London
© Springer International Publishing Switzerland 2016
This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is
concerned, specifi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction
on microfi lms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation,
computer software, or by similar or dissimilar methodology now known or hereafter developed. Exempted from this
legal reservation are brief excerpts in connection with reviews or scholarly analysis or material supplied specifi cally
for the purpose of being entered and executed on a computer system, for exclusive use by the purchaser of the work.
Duplication of this publication or parts thereof is permitted only under the provisions of the Copyright Law of the
Publisher’s location, in its current version, and permission for use must always be obtained from Springer. Permissions
for use may be obtained through RightsLink at the Copyright Clearance Center. Violations are liable to prosecution
under the respective Copyright Law.
T he use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not
imply, even in the absence of a specifi c statement, that such names are exempt from the relevant protective laws and
regulations and therefore free for general use.
While the advice and information in this book are believed to be true and accurate at the date of publication, neither
the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may
be made. The publisher makes no warranty, express or implied, with respect to the material contained herein.
Printed on acid-free and chlorine-free bleached paper
Springer is part of Springer Science+Business Media (www.springer.com)
Foreword
T his book constitutes the proceedings of the 16th International Conference on Brain Edema and
Cellular Injury and the 3rd Symposium on Preconditioning for Neurological Disorders, which
was held at the Hyatt Regency, Huntington Beach, California, on September 27–30, 2014.
The symposium hosted an impressive group of basic scientists and clinicians from North
America, Europe, and Asia.
Sixty-fi ve abstracts were presented over 3 days in three sessions:
Session I Brain Edema and Ion Channels
Session II What Is New in Neural ICU and Edema Management
Session III Experimental Edema Treatment
This symposium was given generous support by:
Platinum Sponsor Integra
Gold Sponsor Sechrist
Awards were presented for the best, well-written abstract in each session:
Poster Awards Group 1 Devin McBride, PhD
Group 2 Elga Esposito, PhD
Group 3 Xian-Hua Chen, PhD
Group 4 Meghan McClure, MD
Oral Awards Clinical Keven Sheth, MD
Changhong Ren, MD, PhD
Basic Science Hua Su, MD, PhD
Rafaella Gesuete, PhD
There were two keynote speakers and three presidential lecturers:
Keynote Speakers Jun Chen, MD, Professor of Neurology and Pharmacology,
University of Pittsburgh
Keynote Speaker Paul Vespa, Professor of Neurology, UCLA
Presidential Lecture Miguel Perez-Pinzon, PhD, Professor of Neurology/Neuroscience,
Director of the Cerebral Vascular Disease Research Center,
Vice-Chair for Basic Science of Neurology, Basic Science Division
Presidential Lecture Guohua Xi, MD, Professor of Neurosurgery Richard C. Schneider
Research Professor, Neurosurgery Associate Director,
Crosby Neurosurgical Laboratories
Presidential Lecture Takeshi Maeda presented for Yoichi Katayama, MD,
Chairman and Professor Department of Neurological Surgery,
Nihon University School of Medicine
CA, USA Robert D. Martin , MD
v
Preface
The 16th International Conference on Brain Edema and Cellular Injury and the 3rd Symposium
on Preconditioning for Neurological Disorders were successfully held in Huntington Beach,
California, from September 27 to 30, 2014. Basic scientists and physician scientists from all
over the world attended and discussed mechanisms and treatments for brain edema, as well as
preconditioning-induced brain protection. This volume contains more than 60 papers from
internationally recognized experts.
Brain edema, an increase in brain water content, can result in increased tissue volume and
increased intracranial pressure. Brain edema is a feature of many different neurological disor-
ders and this was refl ected by the range of presentations at the meeting, from neonatal hypoxia/
ischemia and hemorrhage to adult cerebral ischemia, hemorrhage, and traumatic brain injury.
Brain edema is a major determinant of disease/injury outcome.
In 1967, Dr. Klatzo divided brain edema into two basic types, vasogenic and cytotoxic
edema. Vasogenic edema results from increased blood-brain barrier permeability, whereas
cytotoxic edema is caused by parenchymal cell dysfunction. This classifi cation is still com-
monly used, and this symposium had a range of papers on altered blood-brain barrier function
as well as the mechanisms of parenchymal cell dysfunction in multiple disease states. Although
it is important to understand the mechanisms underlying brain edema formation, it is also
vitally important to translate that information into therapies for treating edema. The treatment
of brain edema has not signifi cantly advanced in decades. The current meeting presented sev-
eral innovative approaches to treat edema experimentally, but it also presented new data on the
current clinical trial on glyburide in ischemic stroke.
M agnetic resonance imaging has advanced signifi cantly over the last decade and can be
used to differentiate vasogenic edema from cytotoxic brain edema. Fluid-attenuated inversion
recovery (FLAIR) is often performed to detect vasogenic edema, and diffusion-weighted
imaging can identify cytotoxic edema. We believe that magnetic resonance imaging and other
imaging techniques will be used even more extensively in brain edema studies in the next
decade.
E xperimental studies suggest that brain edema caused by neurosurgical procedures is pre-
ventable. It is well known that neuroprotection is a major neurosurgical issue where proce-
dures may result in edema, hemorrhage, and/or ischemia. Preconditioning-induced brain
tolerance refers to an endogenous mechanism for brain protection against different kinds of
brain injuries. Preconditioning has been used for heart and brain surgery and is a clinical real-
ity now. In the brain, ischemic preconditioning has been used during clipping of cerebral aneu-
rysm and attenuates tissue hypoxia during aneurysm clipping. Future studies are needed to
develop noninvasive preconditioning methods to reduce brain edema and brain injury.
MI, USA Guohua Xi
MI , USA Richard F. Keep
vii
Contents
General Section
The Evolution of the Clinical Use of Osmotic Therapy
in the Treatment of Cerebral Edema . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Michael N. Diringer
Transcranial Near-Infrared Laser Therapy for Stroke:
How to Recover from Futility in the NEST-3 Clinical Trial . . . . . . . . . . . . . . . . . . . 7
Paul A. Lapchak and Paul D. Boitano
Human Data Supporting Glyburide in Ischemic Stroke . . . . . . . . . . . . . . . . . . . . . . 13
Kevin N. Sheth, J. Marc Simard, Jordan Elm, Golo Kronenberg,
Hagen Kunte, and W. Taylor Kimberly
Mechanisms Underlying Astrocyte Endfeet Swelling in Stroke . . . . . . . . . . . . . . . . 19
J. Xiang, Y. Tang, C. Li, E.J. Su, D.A. Lawrence, and Richard F. Keep
Hypoxia and Infl ammation-Induced Disruptions
of the Blood-Brain and Blood-Cerebrospinal Fluid Barriers
Assessed Using a Novel T- Based MRI Method . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
1
Nabeela Nathoo*, Hamza Jalal*, Sirajedin S. Natah, Qiong Zhang,
Ying Wu, and Jeff F. Dunn
Vascular Integrity in the Pathogenesis of Brain Arteriovenous
Malformation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Rui Zhang, Wan Zhu, and Hua Su
Preconditioning Section
Role of Circulating Immune Cells in Stroke
and Preconditioning- Induced Protection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Raffaella Gesuete, Susan L. Stevens, and Mary P. Stenzel-Poore
Humoral Mediators of Remote Ischemic Conditioning:
Important Role of eNOS/NO/Nitrite . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
David C. Hess, Mohammad Nasrul Hoda, and Mohammad B. Khan
Exsanguination Postconditioning of ICH (EPIC-H) Using the Lancet
for Brain Bleed in Rodents, Preliminary Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Tim Lekic and John H. Zhang
ix
