Ebook: The Human Brain Circulation: Functional Changes in Disease

Much of our knowledge of the cerebral circulation has been derived from studies of species other than human. There is increas­ ing recognition of species differences and concern that studies in animals may be misleading if unquestioningly applied to the human. A dramatic example of this occurred in the early his­ tory of the study of the circulation of the brain. Galen of Pergamo (131-201 AD) described a rete mirabile or "marvelous network" of blood vessels at the base of the human skull that he must have derived from observations of certain animals. This vascular structure was supplied by the carotid arteries which, after penetrating the cranium,"are divided into a large number of very small and thin branches in the region between the cranium and the dura matter. Then . . . intersecting one another they give the impression of having forgotten their way in the brain. But this is not the case. In fact, these numerous arteries rejoin and unite like the roots of a tree trunk. . . . " The authority of Galen's writings dominated scientific thought for about 1500 years. His description of a rete was unques­ tioned by Leonardo de Vinci, who included it in his anatomical sketches. William Harvey's remarkable observations led to his definitive account of the circulation of blood.

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The Human Brain Circulation offers an original, up-to-date synthesis and summary of our current knowledge of the cerebrovascular circulatory system, with special emphasis on the study of isolated vessels. The contributors describe the normal vasculature and the many complex changes that occur with age and disease. Fetal and newborn circulation is also addressed. In areas where knowledge of human vessels is deficient, research on animal tissues is included.

The book is significant because it challenges some of the traditional assumptions based on animal studies of the mechanisms that control human brain vasculature and presents a contemporary view that includes the role of shear stress and intravascular pressure on the arterial circulation.

Among the topics discussed are the receptors for vasoactive substances; the molecular aspects of endothelial function in hemostasis; inflammation and thrombosis; the effect of hypertension; the pathophysiology of vasospasm, ischemia, and reperfusion; and the actions of free radicals. Techniques for the in vivo study of cerebrovascular dysfunction are also described.

The Human Brain Circulation presents a definitive understanding of this centrally important vascular bed and clearly defines the future direction for research into human cerebrovascular disease and its treatment.