The well tempered encephalon

Will J. Sebastian ever forgive me for having got so near to his opera ?
The aim is clear. Using the temperate scale Bach made it possible to transpose a score from one tone to another one, which was instead an impracticable work in not equabile temperamentum.
In the same way, today a unitary clinic behaviour should be transferred from one speciality to another one, not depending on the structure or on the physician to whom cerebro-vascular patient is committed.
Till here the analogy must go, but not over this point, in order to avoid banality.
The analogy anyway is echoed in the choral character of the opera, in its aim of touching all tones and making them vibrate together, not giving privilege to any of them, with a specific multidisciplinarity of the approached topic.
The subject of the volume tries to rejoin, at least at the divulgation level, the ideal fracture between on one side physiopathology and diagnostic studies and on the other side therapeutic practice, which often eludes physiopathology considerations systematically.
Multidisciplinarity of the approach to the patient is mainly stressed, because different competencies join in the treatment of the acute or chronic Cerebro-Vascular Insufficiency (ICV): departments of Neurology, NeuroSurgery, Internal Medicine, Emergency, Vascular Surgery, Cardiology, Angiology, Reanimation and Services of Neuro and AngioRadiology, of Ultrasound Diagnostics, of Imaging Diagnostics.
This multiplicity of professionals gives origin to a fragmented and not integrated treatment with trend impairment, depending on the covered path.
The aim is then to stimulate the adoption of common clinical and diagnostic methods.
The volume expands on several chapters:
PRELUDE - An up-to-date of the actual methods for evaluation of compensation (Doppler and Echo diagnostics of supra-aortic trunks, Transcranial Doppler, Radiology).
SUITE - An unusual matching between topics of Physiopathology and Biophysics of Cerebral Circulation aimed at clinical investigation and of Multi-disciplinary Differential Diagnostics based on instrumentation.
FUGE - Therapeutic points of view, centred on the medical and/or surgical therapy of acute ICV.
DISSONANCE &shyp; The book finishes on the very important topic of the co-ordination between all these therapeutic methods.

Co-ordination is important, because a dis-homogeneity of views exists today, which coexists sometimes with an a priori waiting position, almost a resignation as to therapeutic results, aimed more to the long term functional restore than to the quick action during acute ischemic event.
Finally, I.S.V.B. was the forge, where this initiative really maturated, which well illustrates in every sense the practical character of a healthy utopia, while Centro Diagnostico  celebrates in such a way the thirteenth year of its activity.
A thank to EdiSES which made it possible the realisation of this opera, taking care of its publication carefully, as well as to E.A.S.S., for the availability of the Internet site.

Fausto Passariello
 

Naples, July 31^th 1997, 13.11summer time.