keyword
https://read.qxmd.com/read/34365868/guidelines-on-the-use-of-external-ventricular-drain-and-its-associated-complications-do-we-agree-ii
#21
JOURNAL ARTICLE
Alexandros G Brotis, Marios Karvouniaris, Christos Tzerefos, Charalambos Gatos, Konstantinos N Fountas
Insertion of an external ventricular drain is a common procedure used in everyday practice by neurosurgeons all around the world. It consists of the placement of an external ventricular drain (EVD) into the ventricular system providing the ability to measure intracranial pressure, and also divert the flow of cerebrospinal fluid (CSF) in a variety of pathological conditions. The most common complication is infection, and it may result in devastating consequences and negatively affect the outcome of these patients...
December 2021: British Journal of Neurosurgery
https://read.qxmd.com/read/34331208/a-one-day-prospective-national-observational-study-on-sedation-analgesia-of-patients-with-brain-injury-in-french-intensive-care-units-the-seda-bip-icu-sedation-analgesia-in-brain-injury-patient-in-icu-study
#22
JOURNAL ARTICLE
Simon Poignant, Bernard Vigué, Patricia Balram, Mathieu Biais, Romain Carillon, Vincent Cottenceau, Claire Dahyot-Fizelier, Vincent Degos, Thomas Geeraerts, Patrick Jeanjean, Emmanuel Vega, Sigismond Lasocki, Fabien Espitalier, Marc Laffon
BACKGROUND: Sedation/analgesia is a daily challenge faced by intensivists managing patients with brain injury (BI) in intensive care units (ICUs). The optimization of sedation in patients with BI presents particular challenges. A choice must be made between the potential benefit of a rapid clinical evaluation and the potential exacerbation of intracranial hypertension in patients with impaired cerebral compliance. In the ICU, a pragmatic approach to the use of sedation/analgesia, including the optimal titration, management of multiple drugs, and use of any type of brain monitor, is needed...
February 2022: Neurocritical Care
https://read.qxmd.com/read/34304602/invasive-multimodal-neuromonitoring-in-aneurysmal-subarachnoid-hemorrhage-a-systematic-review
#23
JOURNAL ARTICLE
Michael Veldeman, Walid Albanna, Miriam Weiss, Soojin Park, Anke Hoellig, Hans Clusmann, Raimund Helbok, Yasin Temel, Gerrit Alexander Schubert
BACKGROUND AND PURPOSE: Aneurysmal subarachnoid hemorrhage is a devastating disease leaving surviving patients often severely disabled. Delayed cerebral ischemia (DCI) has been identified as one of the main contributors to poor clinical outcome after subarachnoid hemorrhage. The objective of this review is to summarize existing clinical evidence assessing the diagnostic value of invasive neuromonitoring (INM) in detecting DCI and provide an update of evidence since the 2014 consensus statement on multimodality monitoring in neurocritical care...
November 2021: Stroke; a Journal of Cerebral Circulation
https://read.qxmd.com/read/34184860/management-of-intracranial-hypertension-following-traumatic-brain-injury-a-best-clinical-practice-adoption-proposal-for-intracranial-pressure-monitoring-and-decompressive-craniectomy-joint-statements-by-the-traumatic-brain-injury-section-of-the-italian-society
#24
JOURNAL ARTICLE
Corrado Iaccarino, Laura Lippa, Marina Munari, Carlo A Castioni, Chiara Robba, Anselmo Caricato, Angelo Pompucci, Stefano Signoretti, Gianluigi Zona, Frank A Rasulo
No robust evidence is provided by literature regarding the management of intracranial hypertension following severe traumatic brain injury (TBI). This is mostly due to the lack of prospective randomized controlled trials (RCTs), the presence of studies containing extreme heterogeneously collected populations and controversial considerations about chosen outcome. A scientific society should provide guidelines for care management and scientific support for those areas for which evidence-based medicine has not been identified...
June 2021: Journal of Neurosurgical Sciences
https://read.qxmd.com/read/34111948/neurocritical-care-updates-in-cerebrovascular-disease
#25
REVIEW
Ruchira M Jha, Kevin N Sheth
No abstract text is available yet for this article.
July 2021: Stroke; a Journal of Cerebral Circulation
https://read.qxmd.com/read/33895369/near-infrared-spectroscopy-in-neurocritical-care-a-review-of-recent-updates
#26
JOURNAL ARTICLE
Dmitriy Viderman, Yerkin G Abdildin
Neurocritical diseases and conditions are common causes of long-term disability and mortality. Early recognition and management of neurocritically ill patients is a significant challenge for neurosurgeons, neurologists, and neurointensivists. Although cerebral angiography, magnetic resonance imaging, computed tomography, and radionuclide imaging are useful in neuromonitoring and neuroimaging, they have several important limitations: they are not readily available, cannot be used for a continuous assessment of cerebral function, and frequently require patient transport to the radiological department...
July 2021: World Neurosurgery
https://read.qxmd.com/read/33814896/nutrition-in-the-neurocritical-care-unit-a-new-frontier
#27
REVIEW
Tachira Tavarez, Kelly Roehl, Lauren Koffman
PURPOSE OF REVIEW: This review presents the most current recommendations for providing nutrition to the neurocritical care population. This includes updates on initiation of feeding, immunonutrition, and metabolic substrates including ketogenic diet, cerebral microdialysis (CMD) monitoring, and the microbiome. RECENT FINDINGS: Little evidence exists to support differences in feeding practices among the neurocritical care population. New areas of interest with limited data include use of immunonutrition, pre/probiotics for microbiome manipulation, ketogenic diet, and use of CMD catheters for substrate utilization monitoring...
2021: Current Treatment Options in Neurology
https://read.qxmd.com/read/33732203/silver-jubilee-of-stroke-thrombolysis-with-alteplase-evolution-of-the-therapeutic-window
#28
REVIEW
Yuanmei Pan, Guowen Shi
In 1995, the results of a landmark clinical trial by National Institute of Neurological Disorders and Stroke (NINDS) made a paradigm shift in managing acute cerebral ischemic stroke (AIS) patients at critical care centers. The study demonstrated the efficacy of tissue-type plasminogen activator (tPA), alteplase in improving neurological and functional outcome in AIS patients when administered within 3 h of stroke onset. After about 12 years of efforts and the results of the ECASS-III trial, it was possible to expand the therapeutic window to 4...
2021: Frontiers in Neurology
https://read.qxmd.com/read/33186827/the-effects-of-arterial-co-2-on-the-injured-brain-two-faces-of-the-same-coin
#29
REVIEW
Daniel Agustin Godoy, Maximiliano Rovegno, Christos Lazaridis, Rafael Badenes
Serum levels of carbon dioxide (CO2 ) closely regulate cerebral blood flow (CBF) and actively participate in different aspects of brain physiology such as hemodynamics, oxygenation, and metabolism. Fluctuations in the partial pressure of arterial CO2 (PaCO2 ) modify the aforementioned variables, and at the same time influence physiologic parameters in organs such as the lungs, heart, kidneys, and the gastrointestinal tract. In general, during acute brain injury (ABI), maintaining normal PaCO2 is the target to be achieved...
February 2021: Journal of Critical Care
https://read.qxmd.com/read/33146291/intracerebral-hemorrhage-update-and-future-directions
#30
JOURNAL ARTICLE
Eva Rocha, Carolina Rouanet, Danyelle Reges, Vivian Gagliardi, Aneesh Bhim Singhal, Gisele Sampaio Silva
Intracerebral hemorrhage (ICH), defined as bleeding into the brain parenchyma, is a significant public health issue. Although it accounts for only 10 to 15% of strokes, it is associated with the highest morbidity and mortality rates. Despite advances in the field of stroke and neurocritical care, the principles of acute management have fundamentally remained the same over many years. The main treatment strategies include aggressive blood pressure control, early hemostasis, reversal of coagulopathies, clot evacuation through open surgical or minimally invasive surgical techniques, and the management of raised intracranial pressure...
October 2020: Arquivos de Neuro-psiquiatria
https://read.qxmd.com/read/32937217/temperature-management-in-acute-brain-injury-a-systematic-review-of-clinical-evidence
#31
REVIEW
M Pegoli, Z Zurlo, F Bilotta
UNLABELLED: Temperature alterations in neurocritical care settings are common and have a striking effect on brain metabolism leading to or exacerbating neuronal injury. Hyperthermia worsens acute brain injury (ABI) patients outcome. However conclusive evidence linking control of temperature to improved outcome is still lacking. This review article report an update -results from clinical studies published between March 2006 and March 2020- on the relationship between hyperthermia or Target Temperature Management and functional outcome or mortality in ABI patients...
October 2020: Clinical Neurology and Neurosurgery
https://read.qxmd.com/read/32924623/chameleons-red-herrings-and-false-localizing-signs-in-neurocritical-care
#32
REVIEW
Boyi Li, Tolga Sursal, Christian Bowers, Chad Cole, Chirag Gandhi, Meic Schmidt, Stephan Mayer, Fawaz Al-Mufti
False localizing signs (FLS) and other misleading neurological signs have long been an intractable aspect of neurocritical care. Because they suggest an incorrect location or etiology of the pathological lesion, they have often led to misdiagnosis and mismanagement of the patient. Here, we reviewed the existing literature to provide an updated, comprehensive descriptive review of these difficult to diagnose signs in neurocritical care. For each sign presented, we discuss the non-false localizing presentation of symptoms, the common FLS or misleading presentation, etiology/pathogenesis of the sign, and diagnosis, as well as any other clinically relevant considerations...
June 2022: British Journal of Neurosurgery
https://read.qxmd.com/read/32748210/effect-of-desmopressin-on-platelet-dysfunction-during-antiplatelet-therapy-a-systematic-review
#33
REVIEW
Lise Kjær Andersen, Anne-Mette Hvas, Christine Lodberg Hvas
BACKGROUND AND OBJECTIVE: An increasing number of patients receive antiplatelet therapy. Patients exposed to surgery while receiving platelet inhibitors hold an increased bleeding risk. Especially in neurosurgery and neurocritical care patients, bleeding and hematoma expansion are feared complications as even minor bleedings may be hazardous. The objective of this systematic review was to investigate the effect of desmopressin (1-deamino-8-D-arginine vasopressin, DDAVP) on platelet function during antiplatelet therapy in patients undergoing non-cardiac surgery, patients who experience spontaneous or traumatic hemorrhage, healthy individuals and in animals...
June 2021: Neurocritical Care
https://read.qxmd.com/read/32600958/protecting-the-blossoming-brain-neurocritical-care-in-children
#34
EDITORIAL
Sophia Julia Häfner
This special issue of the Biomedical Journal is entirely dedicated to the latest updates regarding the medical efforts to preserve the fragile young brain after injury. Thereby, we learn about symptoms and diseases such as different forms of epilepsy, acute encephalopathy, increased intracranial pressure, and posthaemorrhagic hydrocephalus, as well as about their origins, such as infection, autoimmune diseases, preterm birth, or abusive head trauma. Moreover, diagnosis and surveillance techniques are discussed, including ultrasound of the optic nerve sheath diameter and multimodal monitoring...
June 2020: Biomedical Journal
https://read.qxmd.com/read/32586726/recent-update-in-pediatric-neurocritical-care-preface
#35
EDITORIAL
Huei-Shyong Wang
No abstract text is available yet for this article.
May 23, 2020: Biomedical Journal
https://read.qxmd.com/read/32335329/point-of-care-ultrasound-of-optic-nerve-sheath-diameter-to-detect-intracranial-pressure-in-neurocritically-ill-children-a-narrative-review
#36
REVIEW
Jainn-Jim Lin, Aaron E Chen, Elaina E Lin, Shao-Hsuan Hsia, Ming-Chou Chiang, Kuang-Lin Lin
The rapid diagnosis of increased intracranial pressure is urgently needed for therapeutic reasons in neurocritically ill children, however this can rarely be achieved without invasive procedures. Point-of-care ultrasound of the optic nerve sheath diameter has been proposed as a non-invasive and reliable means to detect increased intracranial pressure in adults. Accordingly, clinicians may be able to use this technique to initiate early treatment and monitor the effectiveness of treatment in conjunction with other clinical examination and diagnostic modalities...
June 2020: Biomedical Journal
https://read.qxmd.com/read/31983411/continuous-cerebrovascular-reactivity-monitoring-in-moderate-severe-traumatic-brain-injury-a-narrative-review-of-advances-in-neurocritical-care
#37
REVIEW
Frederick A Zeiler, Ari Ercole, Marek Czosnyka, Peter Smielewski, Gregory Hawryluk, Peter J A Hutchinson, David K Menon, Marcel Aries
Impaired cerebrovascular reactivity in adult moderate and severe traumatic brain injury (TBI) is known to be associated with worse global outcome at 6-12 months. As technology has improved over the past decades, monitoring of cerebrovascular reactivity has shifted from intermittent measures, to experimentally validated continuously updating indices at the bedside. Such advances have led to the exploration of individualised physiologic targets in adult TBI management, such as optimal cerebral perfusion pressure (CPP) values, or CPP limits in which vascular reactivity is relatively intact...
January 23, 2020: British Journal of Anaesthesia
https://read.qxmd.com/read/31456054/healthcare-associated-infections-in-the-neurocritical-care-unit
#38
REVIEW
Katharina M Busl
PURPOSE OF REVIEW: This article summarizes updated data and knowledge on healthcare-associated infections in the neurocritical care unit, with a focus on central nervous system infections and systemic infectious complications in patients with acute brain disease. It also reviews the concept of brain injury-induced immune modulation, an underlying mechanism to explain why the neuro-ICU population is particularly susceptible to infections. RECENT FINDINGS: Healthcare-associated infections in the neuro-ICU are common: up to 40 % of meningitides in the developed world are now healthcare-associated...
August 27, 2019: Current Neurology and Neuroscience Reports
https://read.qxmd.com/read/31104615/recommendations-for-the-establishment-of-stroke-systems-of-care-a-2019-update
#39
REVIEW
Opeolu Adeoye, Karin V Nyström, Dileep R Yavagal, Jean Luciano, Raul G Nogueira, Richard D Zorowitz, Alexander A Khalessi, Cheryl Bushnell, William G Barsan, Peter Panagos, Mark J Alberts, A Colby Tiner, Lee H Schwamm, Edward C Jauch
In 2005, the American Stroke Association published recommendations for the establishment of stroke systems of care and in 2013 expanded on them with a statement on interactions within stroke systems of care. The aim of this policy statement is to provide a comprehensive review of the scientific evidence evaluating stroke systems of care to date and to update the American Stroke Association recommendations on the basis of improvements in stroke systems of care. Over the past decade, stroke systems of care have seen vast improvements in endovascular therapy, neurocritical care, and stroke center certification, in addition to the advent of innovations, such as telestroke and mobile stroke units, in the context of significant changes in the organization of healthcare policy in the United States...
July 2019: Stroke; a Journal of Cerebral Circulation
https://read.qxmd.com/read/31092052/an-update-on-neurocritical-care-for-intracerebral-hemorrhage
#40
REVIEW
Ranier Reyes, Meera Viswanathan, Venkatesh Aiyagari
Introduction: Intracerebral hemorrhage remains one of the leading causes of death and disability worldwide with few established interventions that improve neurologic outcome. Research dedicated to better understanding and treating hemorrhagic strokes has multiplied in the past decade. Areas Covered: This review aims to discuss the current landscape of management of intracerebral hemorrhage in a critical care setting and provide updates regarding developments in therapeutic interventions and targets. PubMed was utilized to review recent literature, with a focus on large trials and meta-analyses, which have shaped current practice...
June 2019: Expert Review of Neurotherapeutics
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