Bryce Weir is a high-profile, respected neurologist. Dr. Macdonald is a colleague of Dr. Weir's and is a "rising star" in the field of neurology.
This book is the first to cover all aspects of cerebral vasospasm in depth. It takes the reader from the first descriptions of this puzzling and deadly phenomenon to the latest laboratory evidence explaining its pathophysiology. Packed with clinical pearls, it is a must for neurosurgeons, interventional radiologists, neurologists, and neuropathologists.

Key Features
* Examines the current understanding of vascular smooth muscle physiology
* Provides in-depth overviews of symptoms and treatments
* Written by acknowledged experts on the subject
* Vividly illustrated with beautiful photographs and diagrams
* Cites over 4,000 key papers on vasospasms
* Presents key data in an easy-to-use format

Foreword
Acknowledgments

Abbreviations

Chapter 1 History

I. Introduction

II. Clinical Description

III. Pathology

IV. Radiology

A. Angiography

B. Computed Tomography

C. Blood Flow Measurements

D. Transcranial Doppler

V. Medical Aspects

A. Hemodynamic Therapy

B. Avoidance of Adverse Factors

C. Vasodilator and Neuroprotectant Medication

VI. Etiology

VII. Surgical Aspects

A. Clot Removal

B. Timing of Surgery

C. Angioplasty

VIII. Physiology

IX. State of the Art

X. Farewell Message

References

Chapter 2 Epidemiology

I. Introduction

II. Incidence of Subarachnoid Hemorrhage

III. Incidence of Vasospasm

IV. Timing of Angiography and Incidence of Vasospasm

V. Prognostic Factors for Vasospasm

A. Blood on CT Scan

B. Hypertension

C. Anatomical and Systemic Factors

D. Clinical Grade

E. Antifibrinolytics

F. Age and Sex

G. Smoking

H. Physiological Parameters

I. Hydrocephalus

VI. Factors Unrelated to Vasospasm

VII. Effect of Vasospasm on Outcome

VIII. Influence of Surgery on Vasospasm

IX. Relative Significance of Vasospasm

X. Vasospasm and Cerebral Infarction

XI. The Incidence of Vasospasm over Time

XII. Vasospasm and Nonaneurysmal Subarachnoid Hemorrhage

A. Nonaneurysmal Subarachnoid Hemorrhage

B. Arteriovenous Malformations

C. Other Causes

XIII. Endovascular Coiling and Vasospasm

References

Chapter 3 Hematology

I. Introduction

II. Blood

A. Cellular Elements

B. Plasma

C. Erythrocytes

D. Endothelial Cells

E. Platelets

F. Neutrophils

G. Mast Cells and Basophils

H. Eosinophils

I. Monocytes and Macrophages

J. Lymphocytes

III. Coagulation

A. Coagulation Pathways

B. Coagulation Inhibitors

C. Anticoagulants

D. Fibrinolytics

E. Antifibrinolysis

F. Thrombin

References

Chapter 4 Pathology and Pathogenesis

I. Introduction

II. The Subarachnoid Space, Pia-arachnoid, Arachnoid Villi, and Cerebrospinal Fluid

A. Subarachnoid Space and Pia-Arachnoid

B. Arachnoid Villi

C. Cerebrospinal Fluid

III. Cytopathology of Cerebrospinal Fluid and Subarachnoid Hemorrhage

A. Cellular Responses

B. Red Blood Cell Clearance

IV. Arterial Changes in Vasospasm

A. Systemic Arterial Response to Injury

B. Morphometry of Vasospasm

C. Pathology of Arteries in Vasospasm

D. Changes in Arterial Innervation

E. Arterial Wall Barrier Disruptions

F. The Functional Significance of Morphologic Changes

G. Blood-Brain Barrier

V. Changes in Composition of Cerebrospinal Fluid, Blood, and Adjacent Tissues

A. Cerebrospinal Fluid

B. Changes in Blood Serum and Plasma

C. Changes in Vessel Wall, Leptomeningeal Cells, Brain, and Clot

VI. Cerebral Infarction from Vasospasm

A. Physiology of Aneurysmal Rupture and Vasospasm

B. Impairment of Autoregulation

C. Cerebral Edema

D. Cerebral Volume Changes

E. Cerebrospinal Fluid and Intracranial Pressure

F. Cerebral Blood Flow

G. Cerebral Metabolism

H. Histopathology

I. Clinical Studies of Infarction

References

Chapter 5 Radiology

I. Introduction

II. Angiography

A. Definition and Classification of Angiographic Vasospasm

B. Method of Diagnosis

C. Clinical Series

D. Very Delayed Vasospasm

E. Nonaneurysmal Vasospasm

F. Acute Angiographic Vasospasm

G. Vertebrobasilar Vasospasm

H. Operation and Vasospasm

I. The Venous System and Vasospasm

J. Automated Assessment

K. Mean Transit Time and the Intraparenchymal Circulation

L. Extradural Vasospasm

III. CT Scan

A. Early Demonstration of Subarachnoid Hemorrhage

B. Duration of Subarachnoid Hemorrhage on CT Scan

C. Relationship of Subarachnoid Hemorrhage on CT Scan to Angiographic Vasospasm and Infarction

D. Relationship of Blood on CT Scan to Hydrocephalus

E. Computed Tomographic Prognostic Factors for Poor Outcome

F. Computed Tomographic Demonstration of Ischemic and Hemorrhagic Infarction

G. Quantification of Degree of Subarachnoid Hemorrhage on CT Scan

H. Time Course of Low-Density Areas on CT Scan

I. Demonstration of Rebleeding on CT Scan

J. Effect of Nimodipine on Infarction

K. The Basal Cisterns in Subarachnoid Hemorrhage

L. Computed Tomographic Findings in Patients Dying Early from Subarachnoid Hemorrhage

M. Seizures

N. Coiling of Aneurysms

O. Contrast Enhancement

P. Computed Tomographic Angiographic Direct Demonstration of Vasospasm

IV. Transcranial Doppler Ultrasonography

A. History

B. Technical Aspects

C. Normal Values and Indices

D. Time Course of Velocity Changes

E. Velocity Changes and Angiographic Vasospasm

F. Velocity Changes and Distal Angiographic Vasospasm

G. Velocities, Delayed Ischemic Deficits, and Infarction in Clinical Studies

H. Clinical Factors Affecting Velocities

I. Effect of Age on Velocities

J. Velocities and Blood Pressure

K. Velocities and Physiological Parameters

L. Velocity Changes during Aneurysmal Rupture

M. Velocity Changes during Brain Death

N. Velocity Changes Correlated with Angiographic Diameter

O. Velocity Changes Correlated with Single Photon Emission Computed Tomography Studies

P. The Effect of Hyperosmotic Agents on Velocities

Q. The Transient Hyperemic Response

R. Intracranial Pressure and Velocities

S. Cerebral Blood Flow and Velocities

T. Velocities in Traumatic Subarachnoid Hemorrhage

U. Velocities and Angioplasty

V. The Clinical Value of Transcranial Doppler Ultrasonography

V. Magnetic Resonance Imaging

A. Basic Mechanisms

B. Clinical Series

C. Imaging Techniques

D. Diffusion-Weighted Imaging

E. Magnetic Resonance Spectroscopy

F. Magnetic Resonance Angiography

G. Advantages and Disadvantages

VI. Positron Emission Tomography

A. Changes with Vasospasm

B. Flow and Metabolism with Infarction

C. Oxygen Delivery

VII. Single Photon Emission Computed Tomography

A. History

B. Technique
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