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Neurocritical Care

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https://www.readbyqxmd.com/read/28523595/announcing-current-concepts-exploring-what-is-new-provocative-and-controversial-in-neurocritical-care
#1
EDITORIAL
Stephan A Mayer
No abstract text is available yet for this article.
May 18, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28484930/heart-shaped-bilateral-medullary-pyramidal-infarction-as-a-pathognomonic-finding-of-anterior-spinal-artery-occlusion
#2
Sammy Searcy, Oluwaseun O Akinduro, Andrew Spector, Jang W Yoon, Benjamin L Brown, William D Freeman
BACKGROUND: Unilateral anterior spinal artery (ASA) occlusion resulting in bilateral medullary pyramidal (BMP) infarction is a rare and devastating stroke subtype. We present two cases highlighting the diagnostic and clinical challenges of BMP infarction. METHODS: Case reports and literature review. RESULTS: A 57-year-old man rapidly had severe vomiting and diarrhea 2 h after a meal. Examination revealed bulbar weakness and areflexic tetraplegia...
May 8, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28484929/functional-mri-for-assessment-of-the-default-mode-network-in-acute-brain-injury
#3
Daniel Kondziella, Patrick M Fisher, Vibeke Andrée Larsen, John Hauerberg, Martin Fabricius, Kirsten Møller, Gitte Moos Knudsen
BACKGROUND: Assessment of the default mode network (DMN) using resting-state functional magnetic resonance imaging (fMRI) may improve assessment of the level of consciousness in chronic brain injury, and therefore, fMRI may also have prognostic value in acute brain injury. However, fMRI is much more challenging in critically ill patients because of cardiovascular vulnerability, intravenous sedation, and artificial ventilation. METHODS: Using resting-state fMRI, we investigated the DMN in a convenience sample of patients with acute brain injury admitted to the intensive care unit...
May 8, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28484928/comparison-of-quantitative-characteristics-of-early-post-resuscitation-eeg-between-asphyxial-and-ventricular-fibrillation-cardiac-arrest-in-rats
#4
Bihua Chen, Gang Chen, Chenxi Dai, Pei Wang, Lei Zhang, Yuanyuan Huang, Yongqin Li
BACKGROUND: Quantitative electroencephalogram (EEG) analysis has shown promising results in studying brain injury and functional recovery after cardiac arrest (CA). However, whether the quantitative characteristics of EEG, as potential indicators of neurological prognosis, are influenced by CA causes is unknown. The purpose of this study was designed to compare the quantitative characteristics of early post-resuscitation EEG between asphyxial CA (ACA) and ventricular fibrillation CA (VFCA) in rats...
May 8, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28484927/ethical-and-legal-considerations-in-the-management-of-an-unbefriended-patient-in-a-vegetative-state
#5
Alexandra Lloyd-Smith Sequeira, Ariane Lewis
BACKGROUND: Patients without surrogates are referred to as "unbefriended." Because these patients do not have representatives to assist with medical decision-making, patient autonomy and self-determination, fundamental concepts of American healthcare, are jeopardized. METHODS: We present a case of an unbefriended patient in a vegetative state and discuss the ethical and legal complications associated with management of unbefriended patients. RESULTS: An unbefriended patient was admitted to our hospital with a cardiac arrest in the setting of an intracerebral hemorrhage...
May 8, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28477152/revisiting-grade-3-diffuse-axonal-injury-not-all-brainstem-microbleeds-are-prognostically-equal
#6
Saef Izzy, Nicole L Mazwi, Sergi Martinez, Camille A Spencer, Joshua P Klein, Gunjan Parikh, Mel B Glenn, Steven M Greenberg, David M Greer, Ona Wu, Brian L Edlow
BACKGROUND: Recovery of functional independence is possible in patients with brainstem traumatic axonal injury (TAI), also referred to as "grade 3 diffuse axonal injury," but acute prognostic biomarkers are lacking. We hypothesized that the extent of dorsal brainstem TAI measured by burden of traumatic microbleeds (TMBs) correlates with 1-year functional outcome more strongly than does ventral brainstem, corpus callosal, or global brain TMB burden. Further, we hypothesized that TMBs within brainstem nuclei of the ascending arousal network (AAN) correlate with 1-year outcome...
May 5, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28477151/coagulation-testing-in-intracerebral-hemorrhage-related-to-non-vitamin-k-antagonist-oral-anticoagulants
#7
Jan C Purrucker, Timolaos Rizos, Kirsten Haas, Marcel Wolf, Shujah Khan, Peter U Heuschmann, Roland Veltkamp
BACKGROUND: Intracerebral hemorrhage (ICH) is a life-threatening complication of non-vitamin K antagonist oral anticoagulants (NOAC). Little is known about the effect of intensity of anticoagulation on NOAC-ICH. We describe the current use of coagulation testing in the emergency setting and explore associations with baseline size and expansion of hematoma as determined in a previous study. METHODS: Data from the prospective multicenter RASUNOA registry were analyzed...
May 5, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28451887/bedside-ultrasound-after-decompressive-craniectomy-a-new-standard
#8
EDITORIAL
Tobias Bobinger, Hagen B Huttner, Stefan Schwab
No abstract text is available yet for this article.
April 27, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28439774/albumin-induced-neuroprotection-in-focal-cerebral-ischemia-in-the-alias-trial-does-severity-mechanism-and-time-of-infusion-matter
#9
Rakesh Khatri, Mohammad Rauf Afzal, Gustavo J Rodriguez, Alberto Maud, Muhammad Shah Miran, Mohtashim Arbaab Qureshi, Salvador Cruz-Flores, Adnan I Qureshi
OBJECTIVE: To determine whether there is any differential benefit of albumin administration within 2 h of onset of ischemia and in settings (severe ischemia with reperfusion in cardioembolic strokes with National Institutes of Health Stroke Scale [NIHSS] ≥15), most representative of experimental models of cerebral ischemia in which albumin was effective in reducing neurological injury. BACKGROUND: High-dose intravenous (IV) albumin treatment for acute ischemic stroke (ALIAS) trial did not show overall clinical benefit in ischemic stroke patients in contrast to preclinical studies; however, models of preclinical studies were not completely followed...
April 24, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28432539/early-onset-ventilator-associated-pneumonia-in-patients-with-severe-traumatic-brain-injury-incidence-risk-factors-and-consequences-in-cerebral-oxygenation-and-outcome
#10
Pierre Esnault, Cédric Nguyen, Julien Bordes, Erwan D'Aranda, Ambroise Montcriol, Claire Contargyris, Jean Cotte, Philippe Goutorbe, Christophe Joubert, Arnaud Dagain, Henry Boret, Eric Meaudre
BACKGROUND: Early-onset ventilator-associated pneumonia (EOVAP) occurs frequently in severe traumatic brain-injured patients, but potential consequences on cerebral oxygenation and outcome have been poorly studied. The objective of this study was to describe the incidence, risk factors for, and consequences on cerebral oxygenation and outcome of EOVAP after severe traumatic brain injury (TBI). METHODS: We conducted a retrospective, observational study including all intubated TBI admitted in the trauma center...
April 21, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28405859/effects-of-mild-hypothermia-on-cerebral-large-and-small-microvessels-blood-flow-in-a-porcine-model-of-cardiac-arrest
#11
Junyuan Wu, Wei Yuan, Jiebin Li, Yongzhen Zhao, Jie Li, Zhenhua Li, Chunsheng Li
BACKGROUND: The effect of mild hypothermia (MH) on microcirculation after resuscitation from cardiac arrest is controversial. The aim of this study was to determine whether MH improves or aggravates the disturbance of cerebral microcirculation. METHODS: Twenty domestic male pigs were randomized into the MH group (n = 8), non-hypothermia (NH) group (n = 8) or sham operation group (n = 4). In the MH group, the animals were initiated rapid intravascular cooling at 1 h after return of spontaneous circulation (ROSC) from 8 min ventricular fibrillation, and the core temperature was reduced to 33 °C for 12 h and then rewarmed to 37 °C...
April 12, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28382509/predicting-outcome-in-subarachnoid-hemorrhage-sah-utilizing-the-full-outline-of-unresponsiveness-four-score
#12
F A Zeiler, B W Y Lo, E Akoth, J Silvaggio, A M Kaufmann, J Teitelbaum, M West
BACKGROUND: Existing scoring systems for aneurysmal subarachnoid hemorrhage (SAH) patients fail to accurately predict patient outcome. Our goal was to prospectively study the Full Outline of UnResponsiveness (FOUR) score as applied to newly admitted aneurysmal SAH patients. METHODS: All adult patients presenting to Health Sciences Center in Winnipeg from January 2013 to July 2015 (2.5 year period) with aneurysmal SAH were prospectively enrolled in this study. All patients were followed up to 6 months...
April 5, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28357637/acute-resective-surgery-for-the-treatment-of-refractory-status-epilepticus
#13
Maysaa Merhi Basha, Kushak Suchdev, Monica Dhakar, William J Kupsky, Sandeep Mittal, Aashit K Shah
BACKGROUND: To identify the role of acute surgical intervention in the treatment of refractory status epilepticus (RSE). METHODS: Retrospective review of consecutive patients who underwent epilepsy surgery from 2006 to 2015 was done to identify cases where acute surgical intervention was employed for the treatment of RSE. In addition, the adult and pediatric RSE literature was reviewed for reports of surgical treatment of RSE. RESULTS: Nine patients, aged 20-68 years, with various etiologies were identified to have undergone acute surgical resection for the treatment of RSE, aided by electrocorticography...
March 29, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28357636/probable-catastrophic-antiphospholipid-syndrome-with-intracerebral-hemorrhage-secondary-to-epstein-barr-viral-infection
#14
Mark P Plummer, Adam M H Young, Ronan O'Leary, Maxwell S Damian, Andrea Lavinio
BACKGROUND: Catastrophic antiphospholipid syndrome (CAPS) is a rare, severe variant of antiphospholipid syndrome with a high mortality rate. We report a unique case of CAPS secondary to Epstein-Barr viral (EBV) infection complicated by pulmonary and intracerebral hemorrhage. A review of the CAPS literature relevant to intensive care practice is used to outline a rational approach to diagnosis and management. METHODS: All data are from a single patient admitted to the Neurosciences Critical Care Unit in Addenbrooke's Hospital, Cambridge, in March 2016...
March 29, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28352966/cold-blooded-evaluating-brain-temperature-by-mri-during-surface-cooling-of-human-subjects
#15
Eric J Curran, Daniel L Wolfson, Richard Watts, Kalev Freeman
BACKGROUND: Targeted temperature management (TTM) confers neurological and survival benefits for post-cardiac arrest patients with return of spontaneous circulation (ROSC) who remain comatose. Specialized equipment for induction of hypothermia is not available in the prehospital setting, and there are no reliable methods for emergency medical services personnel to initiate TTM. We hypothesized that the application of surface cooling elements to the neck will decrease brain temperature and act as initiators of TTM...
March 28, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28352965/dual-energy-ct-to-diagnose-pseudoedema-in-contrast-induced-encephalopathy-following-cerebral-angiography
#16
Gabriel L Pagani-Estévez, Deena M Nasr, Waleed Brinjikji, Avital Perry, Jennifer E Fugate
BACKGROUND: Contrast-induced encephalopathy (CIE) is a syndrome that may be clinically unrecognized and misdiagnosed as cerebral edema. METHODS: Case report and review. RESULTS: A 72-year-old woman was admitted for elective endovascular embolization of a 10-mm left anterior communicating artery aneurysm. One hour post-procedure, she acutely developed global aphasia. Emergent head computed tomography (CT) and computed tomography-angiography (CTA) showed high attenuation of the left hemispheric subarachnoid spaces interpreted as hemispheric edema; emergent magnetic resonance imaging revealed left hemispheric punctate infarcts...
March 28, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28337603/multimodal-outcome-prognostication-after-cardiac-arrest-and-targeted-temperature-management-analysis-at-36%C3%A2-%C3%A2-c
#17
Spyridoula Tsetsou, Jan Novy, Christian Pfeiffer, Mauro Oddo, Andrea O Rossetti
BACKGROUND: Targeted temperature management (TTM) represents the standard of care in comatose survivors after cardiac arrest (CA) and may be applied targeting 33° or 36 °C. While multimodal prognostication has been extensively tested for 33 °C, scarce information exists for 36 °C. METHODS: In this cohort study, consecutive comatose adults after CA treated with TTM at 36 °C between July 2014 and October 2016 were included. A combination of neurological examination, electrophysiological features, and serum neuron-specific enolase (NSE) was evaluated for outcome prediction at 3 months (mortality; good outcome defined as cerebral performance categories (CPC) score of 1-2, poor outcome defined as CPC 3-5)...
March 23, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28324264/reverse-locked-in-syndrome
#18
Pooja Raibagkar, Ram V Chavali, Tamara B Kaplan, Jennifer A Kim, Meaghan V Nitka, Sherry H-Y Chou, Brian L Edlow
BACKGROUND: Basilar artery occlusion can cause locked-in syndrome, which is characterized by quadriplegia, anarthria, and limited communication via eye movements. Here, we describe an uncommon stroke syndrome associated with endovascular recanalization of the top of the basilar artery: "reverse locked-in syndrome." METHODS: We report the case of a patient with atypical neurological deficits caused by acute ischemic stroke of the midbrain tegmentum. We perform neuroanatomic localization of the patient's infarcts by mapping the magnetic resonance imaging (MRI) data onto a brainstem atlas...
March 21, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28324263/decannulation-and-functional-outcome-after-tracheostomy-in-patients-with-severe-stroke-decast-a-prospective-observational-study
#19
Hauke Schneider, Franziska Hertel, Matthias Kuhn, Maximilian Ragaller, Birgit Gottschlich, Anne Trabitzsch, Markus Dengl, Marcus Neudert, Heinz Reichmann, Sigrid Wöpking
BACKGROUND: Tracheostomy is performed in ventilated stroke patients affected by persisting severe dysphagia, reduced level of consciousness, or prolonged mechanical ventilation. The study aim was to determine the frequency and predictors of successful decannulation and long-term functional outcome in tracheotomized stroke patients. METHODS: A prospective single-center observational study recruited ventilated patients with ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage...
March 21, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28324262/coxsackie-b3-b4-related-acute-flaccid-myelitis
#20
Sung-Min Cho, Steven MacDonald, Jennifer A Frontera
No abstract text is available yet for this article.
March 21, 2017: Neurocritical Care
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