Brain edema is a simple phenomenon – an abnormal increase of brain tissue volume by the increase of brain tissue water content. However the etiology is not simple and relating to a wide variety of neurological disorders including ischemia, trauma, tumor, hemorrhage and hydrocephalus. It is still a major cause of death in the neurological/neurosurgical ward. This volume is an up-to-date report on progress in brain edema research, diagnosis and treatment, including papers presented at the 12th International Symposium on Brain Edema and Brain Tissue Injury in 2002. Major topics include molecular biology and blood-brain barrier disorders, ischemic and traumatic brain edema, imaging and diagnosis of brain edema, treatment and radiation effect. Various papers in the rapidly growing fields of neuroimaging and molecular medicine are also included.

Brain Edema: From Molecular Mechanisms to Clinical Practice brings together the most widely recognized experts in experimental and clinical brain edema research to review the current knowledge gathered on the molecular and cellular pathophysiology and clinical management of brain edema. This timely book also discusses future directions of research and treatment. Brain edema is an integral and acutely life-threatening part of the pathophysiology of multiple cerebral and non-cerebral disorders, including traumatic brain injury, cerebral ischemia, brain tumors, cardiac arrest, altitude sickness and liver failure. Affecting millions worldwide, research over the past few years has shown that a plethora of complex molecular and cellular mechanisms contribute to this pathological accumulation of water in the brain parenchyma. In parallel, the development of new neuroimaging tools has provided a new way to examine how edema develops longitudinally and in real time, both in pre-clinical models and in patients. Despite intense research over the past few decades, therapeutic options are still limited and sometimes not effective. Presents a comprehensive understanding of the molecular mechanisms involved in edema formation and resolution Discusses the specific role of edema development in several pathologies, including traumatic brain injury, stroke, brain tumors, cardiac arrest, and liver failure Proposes a new classification of edema based on molecular processes Discusses clinical management of new clinical trials coming from pre-clinical studies Addresses the possible link between edema formation, other molecular and cellular processes, including inflammation and neuroinflammation

The control of brain edema is still one of the major problems in surgical and conservative treatment of various cerebral lesions. Many attempts have been made to develop methods for reducing the high mortality associated with brain edema. Mter many years of using hypertonic solutions it can be stated that this type of therapy has not yielded satisfactory results. During recent years increasing evidence has been accumulated on the efficacy of steroids on brain edema. Steroids were reported to result in rapid relief of signs and symptoms of increased intracranial pressure and neurological dysfunction accompanying cerebral edema. It was the aim of this workshop to evaluate the effect of corticosteroids on brain edema as an advance in therapy. It was hoped that this could be achieved by a multi disciplinary approach. Though, the volume contains the contributions of various experts - internists, neurochemists, neurologists, neuropathologists, neurosurgeons, pharmacologists, physiologists - who have added considerable experimental and clin ical evidence on the action of steroids on brain edema. New pathophysiological aspects regarding the mechanisms underlying the formation and resolution of brain The effectiveness of corticosteroid therapy in various forms edema are presented. of clinical and experimental brain edema, e. g. accompanying brain tumors, head injury, spinal cord injury, cerebrovascular lesions, etc. as well as dosage and duration of treatment are critically discussed.

This issue contains the proceedings of the most recent Inter national Symposium on Brain Edema, the 5th in a series of confer ences starting 1965 in Vienna. The ever since increasing interest in this field may not only result from the fact that - in clinical terms - the problem is not solved yet, but also from the many fascinating physiological and biochemical questions remaining. Moreover, the rapid progress of technical, physiological and bio chemical developments provides a permanent challenge to probe the subject with better and better resolution. The current proceedings provide many examples. It is safe to assume, that the history of brain edema research is familiar to most of its participants. Therefore, suffice it to remark that since the first histopathological recognition of brain edema as a separate entity among the multitude of intracranial space occupying lesions, progress in the understanding of its pathogenesis has not been straightforward. On the contrary, it has been complicated by confusing notions and concepts, some of which may have resulted from the elusiveness of the edematous changes in early histological studies, due to the inadequacy of the light microscope. Although brain edema occurs concomitantly in many pgtho10gica1 conditions of the brain, it has been suggested that its role is collateral only. Nevertheless, the potential of brain edema as a space occupying lesion is not trivial, since it raises intracranial pressure and eventually may result in lethal cerebral herniation.