Skip to main content
SpringerLink
Log in

Central Nervous System Response to Trauma

  • Chapter
Pathophysiology of Shock, Sepsis, and Organ Failure

Abstract

The aim of the present chapter is to review aspects of the central nervous organisation of the cardio vascular response to peripheral (non-central ner vous) trauma. Two aspects of “trauma” will be con sidered, namely, haemorrhage or loss of circulating fluid, and tissue damage or “injury”. In the context of this chapter, the term “injury” will be used to denote tissue damage and the associated activation of afferent nociceptive fibres, and does not of itself involve loss of circulating fluid. The responses to haemorrhage and “injury” will initially be con sidered separately, before discussing the interaction between the two responses, and the clinical implica tions of this interaction. Finally, ways in which these responses may be modified by three groups of pharmacological agents: general anaesthetic agents, opioid agonists and antagonists, and ethanol, will be described.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Abraham A (1967) The structure of baroreceptors in pathological conditions in man. In: Kezdi P (ed) Baroreceptors and hypertension. Pergamon, Oxford, pp 273.

    Google Scholar 

  • Acker H, O’Regan RG (1981) The effects of stimulation of autonomic nerves on carotid body blood flow in the cat. J Physiol 315:99.

    PubMed  CAS  Google Scholar 

  • Adair JR, Hamilton BL, Scappaticci KA, Heike CJ, Gillis RA (1977) Cardiovascular responses to elec trical stimulation of the medullary raphe area of the cat. Brain Res 128:141.

    Article  PubMed  CAS  Google Scholar 

  • Alam M, Smirk FH (1937) Observations in man upon a blood pressure raising reflex arising from the volun tary muscles. J Physiol 89:372.

    PubMed  CAS  Google Scholar 

  • Alam M, Smirk FH (1938) Observations in man upon a pulse accelerating reflex from the voluntary muscles of the legs. J Physiol 92:167.

    PubMed  CAS  Google Scholar 

  • Allgöwer M, Burri C (1967) Schockindex. Dtsch Med Wochenschr 43:1.

    Google Scholar 

  • Amione LD, Gebhart GF (1988) Serotonin and/or an ex citatory amino acid mediates stimulation produced antinociception from the lateral hypothalamus in the rat. Brain Res 450:170.

    Article  Google Scholar 

  • Anderson ID, Fairhurst J, Heath DF, Little RA (1988a) Effects of acute ethanol ingestion on the arterial baroreflex in man. J Physiol 403:85P.

    Google Scholar 

  • Anderson ID, Woodford M, DeDombal FT, Irving MH (1988b) Retrospective study of 1000 deaths from in jury in England and Wales. BMJ 296:1305.

    Article  PubMed  CAS  Google Scholar 

  • Anderson ID, Little RA, Irving MH (1990) An effect of trauma on human cardiovascular control: baroreflex suppression. J Trauma 30:974.

    Article  PubMed  CAS  Google Scholar 

  • Andrezik JA, Chan-Palay V, Palay SL (1981) The nucleus paragigantocellularis lateralis in the rat. Demonstration of afferents by retrograde transport of horseradish peroxidase. Anat Embryol 161:373.

    Article  PubMed  CAS  Google Scholar 

  • Angell-James JE (1971) The effects of changes in extra mural, ‘intrathoracic’ pressure on aortic-arch barore ceptors. J Physiol 214:84.

    Google Scholar 

  • Angell-James JE, Daly de MB (1970) Comparison of the reflex vasomotor responses to separate and combined stimulation of the carotid sinus and aortic arch baroreceptors by pulsatile and non-pulsatile pressures in the dog. J Physiol 209:257.

    Google Scholar 

  • Angell-James JE, Daly de MB (1975) Some aspects of upper respiratory tract reflexes. Acta Otolaryngol 79:242.

    Article  PubMed  CAS  Google Scholar 

  • Baker DG, Coleridge HM, Coleridge JCG (1979) Vagal afferent C-fibres from the ventricle. In: Hainsworth R, Kidd C, Lindern RJ (eds) Cardiac receptors. Cam bridge University Press, Cambridge, pp 117.

    Google Scholar 

  • Barcroft H, Edholm OG, McMichael J, Sharpey-Schafer EP (1944) Posthaemorrhagic fainting. Study by car diac output and forearm flow. Lancet i:489.

    Article  Google Scholar 

  • Barriot P, Riou B, Buffat J-J (1987) Pre-hospital management of severe haemorrhagic shock. In: Vincent JL (ed) Update in intensive care and emergency medicine, vol 3. Springer, Berlin Heidelberg New York, pp 377.

    Google Scholar 

  • Basbaum AI, Fields HL (1978) Endogenous pain control mechanisms: review and hypothesis. Ann Neurol 4:451.

    Article  PubMed  CAS  Google Scholar 

  • Beecher HK (1945) Pain in men wounded in battle. Ann Surg 123:96.

    Article  Google Scholar 

  • Bennett JA, Goodchild CS, Kidd C, McWilliam PN (1985) Neurones in the brain stem of the cat excited by vagal afferent fibres from the heart and lungs. J Physiol 369:1.

    PubMed  CAS  Google Scholar 

  • Bennett JA, McWilliam PN, Shepheard SL (1987) A gamma-aminobutyric-acid-mediated inhibition of neurones in the nucleus tractus solitarius of the cat. J Physiol 392:417.

    PubMed  CAS  Google Scholar 

  • Biscoe TJ, Purves MJ, Sampson SR (1970) The frequency of nerve impulses in single carotid body chemoreceptor afferent fibres recorded in vivo with intact circula tion. J Physiol 208:121.

    PubMed  CAS  Google Scholar 

  • Bronk DW, Stella G (1935) The response to steady pressures of single end organs in the isolated carotid sinus. Am J Physiol 110:708.

    Google Scholar 

  • Brown DL, Guyenet PG (1984) Cardiovascular neurons of brain stem with projections to spinal cord. Am J Physiol 247:R1009.

    PubMed  CAS  Google Scholar 

  • Burke SL, Dorward PK (1988) Influence of endogenous opiates and cardiac baroreceptors on renal nerve ac tivity during haemorrhage in conscious rabbits. J Physiol 402:9.

    PubMed  CAS  Google Scholar 

  • Carrive P, Bandler R, Dampney RA (1989) Viscerotopic control of regional vascular beds by discrete groups of neurons within the midbrain periaqueductal gray. Brain Res 493:385.

    Article  PubMed  CAS  Google Scholar 

  • Cohen MI, Montford FP, Gootman PM, Wolotsky P (1974) Synaptic connections between medullary in spiratory neurons and phrenic motoneurons as re vealed by cross correlation. Brain Res 81:319.

    Article  PubMed  CAS  Google Scholar 

  • Cowley AW, Liard JF, Guyton AC (1973) Role of baroreceptor reflex in daily control of arterial blood pressure and other variables in dogs. Circ Res 32:564.

    PubMed  Google Scholar 

  • Cowley AW, Merril D, Osborn J, Barber BJ (1984) In fluence of vasopressin and angiotensin on baroreflex in the dog. Circ Res 54:163.

    PubMed  CAS  Google Scholar 

  • D’Silva JL, Gill D, Mendel D (1966) The effects of acute haemorrhage on respiration in the cat. J Physiol 187:369.

    PubMed  Google Scholar 

  • Daly de MB (1983) Peripheral arterial chemoreceptors and the cardiovascular system. In: Acker H, O’Regan RG (eds) Physiology of the peripheral arterial chemo receptors. Elsevier, Amsterdam, pp 325.

    Google Scholar 

  • Daly de MB, Lambertsen CJ, Schweitzer A (1954) Ob servations on the volume of blood flow and oxygen utilization of the carotid body in the cat. J Physiol 125:67.

    Google Scholar 

  • Daly de MB, Kirkman E, Wood LM (1988) Car diovascular responses to stimulation of cardiac recep tors in the cat and their modification by changes in respiration. J Physiol 407:349.

    Google Scholar 

  • Deitch EA (1990) Intestinal permeability is increased in burn patients shortly after injury. Surgery 107:411.

    PubMed  CAS  Google Scholar 

  • Duggan AW, Morton CR (1983) Periaqueductal grey stimulation: an association between selective inhibi tion of dorsal horn neurones and changes in periph eral circulation. Pain 15:237.

    Article  PubMed  CAS  Google Scholar 

  • Ellenberger HH, Feldman JL (1988) Monosynaptic transmission of respiratory drive to phrenic motoneu rons from brainstem bulbospinal neurons in rats. J Comp Neurol 269:47.

    Article  PubMed  CAS  Google Scholar 

  • Eltrafi A, Kirkman E, Little RA (1989) Reversal of the injury induced reduction in baroreflex sensitivity by naloxone in the conscious rat. Br J Pharmacol 96:145.

    Google Scholar 

  • Evans RG, Ludbrook J, Van Leeuwen AF (1989a) Role of central opiate receptor subtypes in the circulatory responses of awake rabbits to graded caval occlusions. J Physiol 419:15.

    PubMed  CAS  Google Scholar 

  • Evans RG, Ludbrook J, Potocnik SJ (1989b) Intracisternal naloxone and cardiac nerve blockade prevent vasodilatation during simulated haemorrhage in awake rabbits. J Physiol 409:1.

    PubMed  CAS  Google Scholar 

  • Fine J (1961) Endotoxins in traumatic shock. Fed Proc 20[Suppl 9]: 166.

    PubMed  Google Scholar 

  • Fulwiler CE, Saper CB (1984) Subnuclear organization of the efferent connections of the parabrachial nucleus in the rat. Brain Res Rev 7:229.

    Article  Google Scholar 

  • Garcia M, Jordan D, Spyer KM (1978) Studies on the properties of cardiac vagal neurones. Neurosci Lett [Suppl] 1:S16.

    Google Scholar 

  • Gong QL, Li P (1989) Inhibitory effect of nucleus raphe obscurus on the pressor response to stimulation of the hypothalamic and midbrain defence areas in the anaesthetized rabbit. J Physiol 418:85P.

    Google Scholar 

  • Henry JL, Calaresu FR (1972) Topography and numeri cal distribution of neurons of the thoraco-lumbar in-termediolateral nucleus in the cat. J Comp Neurol 144:205.

    Article  PubMed  CAS  Google Scholar 

  • Heymans C, Neil E (1958) Reflexogenic areas of the car diovascular system. Churchill, London.

    Google Scholar 

  • Hilton SM, Redfern WS (1986) A search for brain stem cell groups integrating the defence reaction in the rat. J Physiol 378:213.

    PubMed  CAS  Google Scholar 

  • Hilton SM, Marshall JM, Timms RJ (1983) Ventral medullary relay neurones in the pathway from the defence areas of the cat and their effect on blood pressure. J Physiol 345:149.

    PubMed  CAS  Google Scholar 

  • Howard JM, Artz CP, Stahl RR (1955) The hypertensive response to injury. Ann Surg 141:327.

    Article  PubMed  CAS  Google Scholar 

  • Jones RO (1989) The identification of the brain areas in volved in the interaction between peripheral injuries and baroreceptor reflex activity in the rat. PhD thesis, University of Manchester.

    Google Scholar 

  • Jones RO, Kirkman E, Little RA (1990) The involvement of the midbrain periaqueductal grey in the cardiovas cular response to injury in the conscious and anaes thetized rat. Exp Physiol 75:483.

    PubMed  CAS  Google Scholar 

  • Jordan D, Khalid MEM, Schneiderman N, Spyer KM (1982) The location and properties of preganglionic vagal cardiomotor neurones in rabbit. Pflügers Arch 395:244.

    Article  PubMed  CAS  Google Scholar 

  • Jordan D, Khalid MEM, Schneiderman N, Spyer KM (1980) The inhibitory control of vagal cardiomotor neurones. J Physiol 301:54P.

    Google Scholar 

  • Jung R, Bruce EN, Katona PG (1991) Cardiorespiratory responses to glutamatergic antagonists in the caudal ventrolateral medulla of rats. Brain Res 564:286.

    Article  PubMed  CAS  Google Scholar 

  • Kenney RA, Neil E (1951) The contribution of aortic chemoreceptor mechanisms to the maintenance of ar terial blood pressure of cats and dogs after haemor rhage. J Physiol 112:223.

    PubMed  CAS  Google Scholar 

  • Kirchheim H (1976) Systemic arterial baroreceptor re flexes. Physiol Rev 56:100.

    PubMed  CAS  Google Scholar 

  • Kirkman E, Scott EM (1983) The effect of changes in plasma renin activity on the baroreceptor reflex arc in the cat. J Physiol 342:73P.

    Google Scholar 

  • Kirkman E, Marshall HW, Heyworth J, Little RA (1990) Ethanol potentiates the reflex bradycardia elicited by stimulating cardiac C-fibre afferents in the anaes thetised dog. Br J Pharmacol 99:22P.

    Google Scholar 

  • Kirkman E, Marshall HW, Little RA (1992) Modulation by anaesthetic agents of the reflex cardio-inhibitory responses to activation of the baroreflex and the car diopulmonary C-fibre afferents in the rat. Br J Phar macol (in press).

    Google Scholar 

  • Knoche H, Addicks K (1976) Electron microscopic studies of the pressorreceptor fields of the carotid sinus in the dog. Cell Tissue Res 173:77.

    Article  PubMed  CAS  Google Scholar 

  • Krauss JM (1979) Structure of the rat aortic baroreceptors and their relationship to connective tissue. J Neurocytol 8:401.

    Article  Google Scholar 

  • Lewis T (1932) Vasovagal syncope and the carotid sinus mechanism. Br Med J i:873.

    Article  Google Scholar 

  • Little RA, Randall PE, Redfern WS, Stoner HB, Marshall HW (1984) Components of injury (haemor rhage and tissue ischaemia) affecting cardiovascular reflexes in man and rat. QJ Exp Physiol 69:753.

    CAS  Google Scholar 

  • Little RA, Jones RO, Eltraifi AE (1988) Cardiovascular reflex function after injury. Prog Clin Biol Res 264:191–200.

    PubMed  CAS  Google Scholar 

  • Little RA, Marshall HW, Kirkman E (1989) Attenuation of the acute cardiovascular responses to haemorrhage by tissue injury in the conscious rat. QJ Exp Physiol 74:825.

    CAS  Google Scholar 

  • Little RA, Gorman D, Allgöwer M (1990) The shock in dex revisited. In: Vincent JL (ed) Update in intensive care and emergency medicine, vol 10. Springer, Berlin Heidelberg New York, pp 505–512.

    Google Scholar 

  • Loewy AD, Burton H (1978) Nuclei of the solitary tract: efferent projections to the lower brain stem and spinal cord of the cat. J Comp Neurol 181:421.

    Article  PubMed  CAS  Google Scholar 

  • Lovick TA (1985a) Ventrolateral medullary lesions block the antinociceptive and cardiovascular responses elicited by stimulating the dorsal periaqueductal grey matter in rats. Pain 21:241.

    Article  PubMed  CAS  Google Scholar 

  • Lovick TA (1985b) Projections from the diencephalon and mesencephalon to nucleus paragigantocellularis lateralis in the cat. Neuroscience 14:853.

    Article  PubMed  CAS  Google Scholar 

  • Lovick TA (1986a) Analgesia and the cardiovascular changes evoked by stimulating neurones in the ven trolateral medulla in rats. Pain 25:259.

    Article  PubMed  CAS  Google Scholar 

  • Lovick TA (1986b) Projections from brainstem nuclei to the nucleus paragigantocellularis lateralis in the cat. J Auton Nerv Syst 16:1.

    Article  PubMed  CAS  Google Scholar 

  • Lovick TA (1987a) Differential control of cardiac and vasomotor activity by neurones in nucleus paragigan tocellularis lateralis in the cat. J Physiol 389:23.

    PubMed  CAS  Google Scholar 

  • Lovick TA (1987b) Tonic GABAergic and cholinergic in fluences on pain control and cardiovascular control neurones in nucleus paragigantocellularis lateralis in the rat. Pain 31:401.

    Article  PubMed  CAS  Google Scholar 

  • Lovick TA (1988a) Convergent afferent imports to neu rones in nucleus paragigantocellularis lateralis in the cat. Brain Res 456:183.

    Article  PubMed  CAS  Google Scholar 

  • Lovick TA (1988b) GABA-mediated inhibition in nucle us paragigantocellularis lateralis in the cat. Neurosci Lett 92:182.

    Article  PubMed  CAS  Google Scholar 

  • Lovick TA (1989a) Cardiovascular response to 5HT in the ventrolateral medulla of the rat. J Auton Nerv Syst 28:35.

    Article  PubMed  CAS  Google Scholar 

  • Lovick TA (1989b) Effect of 5HT in the ventrolateral medulla on the pressor response and analgesia evoked by stimulation of the dorsal periaqueductal grey mat ter in anaesthetized rats. J Physiol 418:84P.

    Google Scholar 

  • Ludbrook J, Rutter PC (1988) Effect of naloxone on haemodynamic responses to acute blood loss in unanaesthetized rabbits. J Physiol 400:1.

    PubMed  CAS  Google Scholar 

  • Martin GF, Humbertson AO, Laxon C, Panneton WM (1979) Evidence for direct bulbospinal projections to laminae IX, X and the intermediolateral cell column. Studies using axonal transport techniques in the North American opossum. Brain Res 170:165.

    Article  PubMed  CAS  Google Scholar 

  • McAllen RM (1976) Inhibition of the baroreceptor input to the medulla by stimulation of the hypothalamic defence area. J Physiol 257:45 P.

    Google Scholar 

  • McAllen RM, Dampney RA (1990) Vasomotor neurons in the rostral ventrolateral medulla are organized topographically with respect to type of vascular bed but not body region. Neurosci Lett 110:91.

    Article  PubMed  CAS  Google Scholar 

  • McAllen RM, Spyer KM (1976) The location of cardiac vagal preganglionic motorneurones projecting to the heart and lungs. J Physiol 282:353.

    Google Scholar 

  • McCall RB (1984) Evidence for a serotonergically mediated sympathoexcitatory response to stimulation of medullary raphe nuclei. Brain Res 311:131.

    Article  PubMed  CAS  Google Scholar 

  • McCall RB (1988) GABA-mediated inhibition of sympatho-excitatory neurons by midline medullary stimu lation. Am J Physiol 255:R605.

    PubMed  CAS  Google Scholar 

  • Mifflin SW, Spyer KM, Withington-Wray DJ (1988) Baroreceptor inputs to the nucleus tractus solitarius in the cat: modulation by the hypothalamus. J Physiol 399:369.

    PubMed  CAS  Google Scholar 

  • Morilak DA, Somogyi P, McIlhinney RAJ, Chalmers J (1989) An enkephalin-containing pathway from nu cleus tractus solitarius to the pressor area of the rostral ventrolateral medulla of the rabbit. Neurosci ence 31:187.

    Article  CAS  Google Scholar 

  • Morrison SF, Callaway J, Milner TA, Reis DJ (1991) Rostral ventrolateral medulla: a source of the glutamatergic innervation of the sympathetic in termediolateral nucleus. Brain Res 562:126.

    Article  PubMed  CAS  Google Scholar 

  • Öberg B, Thorén P (1972) Increased activity in left ven tricular receptors during haemorrhage on occlusion of the caval veins in the cat. A possible cause of the vasovagal reaction. Acta Physiol Scand 85:164.

    Article  PubMed  Google Scholar 

  • Öberg B, Thorén P (1973) Circulatory response to stimu lation of left ventricular receptors in the cat. Acta Physiol Scand 88:8

    Article  PubMed  Google Scholar 

  • Overman RR, Wang SC (1947) The contributory role of the afferent nervous factor in experimental shock: sublethal haemorrhage and sciatic nerve stimulation. Am J Physiol 148:289.

    PubMed  CAS  Google Scholar 

  • Potter EK, McCloskey DI (1987) Excitation of carotid body chemoreceptors by neuropeptide-Y. Respir Physiol 67:357.

    Article  PubMed  CAS  Google Scholar 

  • Praag H, Frenk H (1990) The role of glutamate in opiate descending inhibition of nociceptive spinal reflexes. Brain Res 524:101.

    Article  PubMed  Google Scholar 

  • Quest JA, Gebber GL (1972) Modulation of baroreceptor reflexes by somatic afferent nerve stimulation. Am J Physiol 222:1251.

    PubMed  CAS  Google Scholar 

  • Rady M, Little RA, Edwards JD, Kirkman E, Faithfull S (1991) The effect of nociceptive stimulation on the changes in hemodynamics and oxygen transport in duced by hemorrhage in anaesthetized pigs. J Trauma 31:617.

    Article  PubMed  CAS  Google Scholar 

  • Redfern WS (1981) Effects of limb ischaemia on the car diac component of the baroreceptor reflex in the unanaesthetized rat — afferent, central and efferent mechanisms. PhD thesis, University of Manchester.

    Google Scholar 

  • Redfern WS, Little RA, Stoner HB, Marshall HW (1984) Effect of limb ischaemia on blood pressure and the blood pressure-heart rate reflex in the rat. QJ Exp Physiol 69:763.

    CAS  Google Scholar 

  • Ross CA, Ruggiero DA, Joh TH, Park DH, Reis DJ (1984) Rostral ventrolateral medulla: selective projec tions to the thoracic autonomic cell column from the region containing C1 adrenaline neurons. J Comp Neurol 228:168.

    Article  PubMed  CAS  Google Scholar 

  • Secher NH, Bie P (1985) Bradycardia during reversible haemorrhagic shock — a forgotten observation? Clin Physiol 5:315.

    Article  PubMed  CAS  Google Scholar 

  • Seller H (1991) Central baroreceptor reflex pathways. In: Kirchheim HR, Persson PB (eds) Baroreceptor re flexes: integrative functions and clinical aspects. Springer, Berlin Heidelberg New York, pp 45.

    Google Scholar 

  • Siddall PJ, Dampney RA (1989) Relationship between cardiovascular neurones and descending antinocicep tive pathways in the rostral ventrolateral medulla of the cat. Pain 37:347.

    Article  PubMed  CAS  Google Scholar 

  • Spyer KM (1984) Central control of the cardiovascular system. Rec Adv Physiol 10:163.

    Google Scholar 

  • Swan KG, Vidaver RM, Lavigne JE, Brown CS (1977) Acute alcoholism, minor trauma and “shock”. J Trauma 17:215.

    Article  PubMed  CAS  Google Scholar 

  • Terui N, Saeki Y, Kumada M (1987) Confluence of barosensory and nonbarosensory inputs at neurons in the ventrolateral medulla in rabbits. Can J Physiol Pharmacol 65:1584.

    Article  PubMed  CAS  Google Scholar 

  • Uhl GR, Goodman RR, Kuhar MJ, Childers SR, Snyder SH (1979) Immunohistochemical mapping of en kephalin containing cell bodies, fibres and nerve ter minals in the brain stem of the rat. Brain Res 166:75.

    Article  PubMed  CAS  Google Scholar 

  • Wang Q, Guo X-Q, Li P (1988) The inhibitory effects of somatic input on the excitatory responses of vagal cardiomotor neurones to stimulation of the nucleus tractus solitarius in rabbits. Brain Res 439:350.

    Article  PubMed  CAS  Google Scholar 

  • Ward DG (1989) Neurons in the parabrachial nuclei re spond to hemorrhage. Brain Res 491:80.

    Article  PubMed  CAS  Google Scholar 

  • Ward DG, Darlington DN (1987) Lesions of the caudal periaqueductal gray prevent compensation of arterial pressure during haemorrhage. Brain Res 407:369.

    Article  PubMed  CAS  Google Scholar 

  • West J, Trunkey DD, Lim RC (1979) Systems of trauma care. Arch Surg 114:455.

    Article  PubMed  CAS  Google Scholar 

  • Wilmore DW, Smith RJ, O’Dwyer ST, Jackobs DO, Ziegler TR, Wang X-D (1988) The gut: a central organ after surgical stress. Surgery 104:917.

    PubMed  CAS  Google Scholar 

  • Yardley CP, Hilton SM (1986) The hypothalamic and brainstem areas from which the cardiovascular and behavioural components of the defence reaction are elicited in the rat. J Auton Nerv Syst 15:227.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. North Western Injury Research Centre, Stopford Building, University of Manchester, Manchester, M13 9PT, Great Britain

    E. Kirkman & R. A. Little

Authors
  1. E. Kirkman
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. R. A. Little
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Ludwig-Boltzmann Institute for Experimental and Clinical Traumatology, Donaueschingenstraße 13, A-1200, Vienna, Austria

    Günther Schlag M. D.  & Heinz Redl Ph. D.  & 

Rights and permissions

Reprints and permissions

Copyright information

© 1993 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Kirkman, E., Little, R.A. (1993). Central Nervous System Response to Trauma. In: Schlag, G., Redl, H. (eds) Pathophysiology of Shock, Sepsis, and Organ Failure. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-76736-4_27

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-76736-4_27

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-76738-8

  • Online ISBN: 978-3-642-76736-4

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation