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[Pathophysiologic aspects of conservative therapy of post-traumatic cerebrovascular disorders of the
B Reichmuth1, U Meier, M Michalik
1Abteilung Neurologie, Bereichs Medizin (Charité) der Humboldt-Universität zu Berlin.
In order to avoid or diminish secondary cerebral damage in the treatment of the craniocerebral trauma the removal of disturbances of the microcirculation is of decisive importance to the course of the disease and the prognosis. The microcirculation is essentially determined by rheological factors such as haematocrit, plasma viscosity, aggregation and fluidity of erythrocytes. Rheological aspects should be included to a greater extent than has been done until now in the basic therapy of traumatic cerebral blood supply disturbances. If this is not done, an important therapeutic reserve is not made use of. In our opinion isovolaemic haemodilution is a practical method. The application of cerebroselective calcium antagonists appears to be reasonable as well.
In order to avoid or diminish secondary cerebral damage in the treatment of the craniocerebral trauma the removal of disturbances of the microcirculation is of decisive importance to the course of the disease and the prognosis. The microcirculation is essentially determined by rheological factors such as haematocrit, plasma viscosity, aggregation and fluidity of erythrocytes. Rheological aspects should be included to a greater extent than has been done until now in the basic therapy of traumatic cerebral blood supply disturbances. If this is not done, an important therapeutic reserve is not made use of. In our opinion isovolaemic haemodilution is a practical method. The application of cerebroselective calcium antagonists appears to be reasonable as well.