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This point where the last branch of the IMAis joined by thesuperior hemorrhoidal artery from the internal iliac artery is a watershed area and an areaof possible ischemia. CCS cases vary in length from10 to 25 minutes in duration.

Int J Geriatr Psychiatry, 22 (4): 356–360.Saczynski, J.S., Pfeifer, L.A., Masaki, K., et al. The levels ofthese hormones, however, were greater in patients compared tocontrols7 (Figure 4). In general, the stimula-tion of afferent pathways back to the central nervoussystem results in release of neuropeptides such asopioids, serotonin, and the endocannabanoids (33).The end result is an influence on sympathetic andparasympathetic outflow to the heart and elsewhere,depending on the acupoint used. N Engl J Med 2009;361:2066–78Cosnes J, Gower-Rousseau C, Seksik P, Cortot A

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Critical care management of patients follow-ing aneurysmal subarachnoid hemorrhage: recommendations from the Neurocritical Care Society’sMultidisciplinary Consensus Conference. They can also arise from the sequestra-tion of platelets by the spleen or consumption of plateletsdue to coagulation within the vasculature

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