Ischaemia in Head Injury

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One of the best attended satellite symposia at the 1995 Neurosurgical Congress in Berlin was on ischaemia in head injury. Its aim, according to its chairman, Professor Francois Cohadon of Bordeaux, was primarily to review the current concept of brain ischaemia in trauma, its diagnosis and its clinical management. Professor Cohadon himself is pre-eminent in the field of accident and emergency surgery in France. Introducing the other speakers, he welcomed Professor Graham Teasdale of Glasgow and Dr Mark Dearden, now of Leeds, as products of the Scottish schools of traumatic neurosurgery. He was especially pleased to see in the audience Professor Jennett, the father of these schools, to which, Professor Cohadon said, all neurosurgeons are indebted for in­ numerable major contributions to our understanding of traumatic brain injury. Professor Nicholas Dorsch of Westmead Hospital, New South Wales, Australia, and Dr Kakarieka of the Bayer Research Group, were the two final speakers. Professor Cohadon introduced the concept of secondary damage after brain trauma. Professor Teasdale described the pathological and clinical evidence of ischaemic damage in brain trauma, and Dr Dearden described its mechanisms and methods for the clinical monitoring of the threat to patients. Professor Dorsch described the role of traumatic subarachnoid haemorrhage (TSAH) in causing vasospasm after brain trauma, and the consequences for eventual recovery. The meeting was completed by Dr Kakarieka, who gave the first report on a randomized, con­ trolled trial of nimodipine in patients with TSAH.