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https://www.readbyqxmd.com/read/28339483/temporal-evolution-of-vasospasm-and-clinical-outcome-after-intra-arterial-vasodilator-therapy-in-patients-with-aneurysmal-subarachnoid-hemorrhage
#1
Laleh Daftari Besheli, Can Ozan Tan, Donnie L Bell, Joshua A Hirsch, Rajiv Gupta
Intra-arterial (IA) vasodilator therapy is one of the recommended treatments to minimize the impact of aneurysmal subarachnoid hemorrhage-induced cerebral vasospasm refractory to standard management. However, its usefulness and efficacy is not well established. We evaluated the effect IA vasodilator therapy on middle cerebral artery blood flow and on discharge outcome. We reviewed records for 115 adults admitted to Neurointensive Care Unit to test whether there was a difference in clinical outcome (discharge mRS) in those who received IA infusions...
2017: PloS One
https://www.readbyqxmd.com/read/28335668/directions-for-use-of-intracranial-pressure-monitoring-in-treatment-of-severe-traumatic-brain-injury-using-data-from-the-japan-neurotrauma-data-bank
#2
Eiichi Suehiro, Yuichi Fujiyama, Hiroyasu Koizumi, Michiyasu Suzuki
Neuromonitoring can be used to observe intracranial pathological conditions in neurointensive care, but use of intracranial pressure (ICP) monitoring is low in Japan. In this study, we retrospectively investigated the effects of ICP monitoring in treatment of severe traumatic brain injury (TBI) using data from the Japan Neurotrauma Data Bank (JNTDB). The study was conducted in 1,091 subjects enrolled in the JNTDB (Project 2009) from July 2009 to June 2011. The subjects were divided into those treated with and without ICP monitoring in intensive care for severe TBI...
March 23, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28295447/effectiveness-and-tolerability-of-conivaptan-and-tolvaptan-for-the-treatment-of-hyponatremia-in-neurocritically-ill-patients
#3
Caroline Der-Nigoghossian, Christine Lesch, Karen Berger
STUDY OBJECTIVE: To describe the effectiveness and tolerability of conivaptan and tolvaptan for the correction of hyponatremia in neurocritically ill patients. DESIGN: Retrospective cohort study. SETTING: Neurointensive care units at two academic medical centers. PATIENTS: Thirty-six adults admitted to the neurocritical care unit who received at least one dose of conivaptan (5 patients) or tolvaptan (31 patients) between June 2012 and May 2013...
March 12, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28259232/guillain-barr%C3%A3-syndrome
#4
REVIEW
Eelco F M Wijdicks, Christopher J Klein
Guillain-Barré syndrome is an acute inflammatory immune-mediated polyradiculoneuropathy presenting typically with tingling, progressive weakness, and pain. Variants and formes frustes may complicate recognition. The best known variant is the sensory ataxic form of Miller Fisher syndrome, which also affects the oculomotor nerves and the brain stem. Divergent pathologic mechanisms lead to demyelinating, axonal, or mixed demyelinating-axonal damage. In the demyelinating form, yet to be identified antigens are inferred by complement activation, myelin destruction, and macrophage-activated cleanup...
March 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28230563/implementation-of-an-early-mobility-pathway-in-neurointensive-care-unit-patients-with-external-ventricular-devices
#5
Megan Moyer, Bethany Young, Joseph Borst, William Pino, Marisa Hart, Jesse LoBreglio, Derek Zaleski, Isaira Leonor, David Kung, Michelle Smith, Eric Zager, M Sean Grady, Monisha Kumar
BACKGROUND: Patients with an external ventricular drain (EVD) may not be readily mobilized because of concerns of catheter dislodgment and/or inappropriate cerebrospinal fluid drainage. Delayed mobilization may result in longer hospital stays and an increased risk for complications related to immobility. We aimed to determine the safety, feasibility, and outcome of an EVD mobilization protocol in patients with subarachnoid hemorrhage (SAH). METHODS: A multidisciplinary group developed a formal algorithm for the mobilization of patients with SAH with EVDs...
February 23, 2017: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/28187810/management-of-infections-associated-with-neurocritical-care
#6
REVIEW
L Rivera-Lara, W Ziai, P Nyquist
The reported incidence of hospital-acquired infections (HAIs) in the neurointensive care unit (NICU) ranges from 20% to 30%. HAIs in US hospitals cost between $28 and $45 billion per year in direct medical costs. These infections are associated with increased length of hospital stay and increased morbidity and mortality. Infection risk is increased in NICU patients due to medication side-effects, catheter and line placement, neurosurgical procedures, and acquired immune suppression secondary to steroid/barbiturate use and brain injury itself...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28187800/management-of-aneurysmal-subarachnoid-hemorrhage
#7
REVIEW
N Etminan, R L Macdonald
Spontaneous subarachnoid hemorrhage (SAH) affects people with a mean age of 55 years. Although there are about 9/100 000 cases per year worldwide, the young age and high morbidity and mortality lead to loss of many years of productive life. Intracranial aneurysms account for 85% of cases. Despite this, the majority of survivors of aneurysmal SAH have cognitive deficits, mood disorders, fatigue, inability to return to work, and executive dysfunction and are often unable to return to their premorbid level of functioning...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28060220/predictive-factors-that-may-contribute-to-secondary-insults-with-nursing-interventions-in-adults-with-traumatic-brain-injury
#8
Lena Nyholm, Tim Howells, Per Enblad
BACKGROUND: Nursing interventions pose risks and benefits to patients with traumatic brain injury at a neurointensive care unit. OBJECTIVES: The aim of this study was to investigate the risk of inducing high intracranial pressure (ICP) related to interventions and whether intracranial compliance, baseline ICP, or autoregulation could be used as predictors. METHODS: The study had a quantitative, prospective, observational design. Twenty-eight patients with TBI were included, and 67 interventions were observed...
February 2017: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
https://www.readbyqxmd.com/read/27994358/retrospective-analysis-of-multiplex-polymerase-chain-reaction-based-molecular-diagnostics-ses-in-70-patients-with-suspected-central-nervous-system-infections-a-single-center-study
#9
Rama Krishnan Tiruppur Chinnappan Ramalingam, Dipanjan Chakraborty
BACKGROUND: Central nervous system (CNS) infections present a grave health care challenge due to high morbidity and mortality. Clinical findings and conventional laboratory assessments are not sufficiently distinct for specific etiologic diagnosis. Identification of pathogens is a key to appropriate therapy. AIM: In this retrospective observational study, we evaluated the efficacy and clinical utility of syndrome evaluation system (SES) for diagnosing clinically suspected CNS infections...
October 2016: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/27982770/the-semisitting-position-analysis-of-the-risks-and-surgical-outcomes-in-a-contemporary-series-of-425-adult-patients-undergoing-cranial-surgery
#10
Andrea Saladino, Massimo Lamperti, Antonella Mangraviti, Federico G Legnani, Francesco U Prada, Cecilia Casali, Luigi Caputi, Paola Borrelli, Francesco DiMeco
OBJECTIVE The objective of this study was to analyze the incidence of the primary complications related to positioning or surgery and their impact on neurological outcome in a consecutive series of patients undergoing elective surgery in the semisitting position. METHODS The authors prospectively collected and retrospectively analyzed data from adult patients undergoing elective surgery in the semisitting position for a cranial disease. Patients were managed perioperatively according to a standard institutional protocol, a standardized stepwise positioning, and surgical maneuvers to decrease the risk of venous air embolism (VAE) and other complications...
December 16, 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/27966092/attitudes-of-patients-and-relatives-toward-disability-and-treatment-in-malignant-mca-infarction
#11
Hermann Neugebauer, Matthias Schnabl, Dorothée Lulé, Peter U Heuschmann, Eric Jüttler
BACKGROUND: Attitudes among patients and relatives toward the degree of acceptable disability and the importance of aphasia are critical in deciding on decompressive hemicraniectomy (DHC) in malignant middle cerebral artery infarction (MMI). However, most MMI patients are not able to communicate their will. Furthermore, attitudes of healthy individuals and relatives may not correspond to those of stroke patients. METHODS: This is a multicenter survey among 355 patients and 199 relatives during treatment for acute minor or moderate severe ischemic stroke in Germany...
December 13, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27930420/performance-of-spectrogram-based-seizure-identification-of-adult-eegs-by-critical-care-nurses-and-neurophysiologists
#12
Edilberto Amorim, Craig A Williamson, Lidia M V R Moura, Mouhsin M Shafi, Nicolas Gaspard, Eric S Rosenthal, Mary M Guanci, Venkatakrishna Rajajee, M Brandon Westover
PURPOSE: Continuous EEG screening using spectrograms or compressed spectral arrays (CSAs) by neurophysiologists has shorter review times with minimal loss of sensitivity for seizure detection when compared with visual analysis of raw EEG. Limited data are available on the performance characteristics of CSA-based seizure detection by neurocritical care nurses. METHODS: This is a prospective cross-sectional study that was conducted in two academic neurocritical care units and involved 33 neurointensive care unit nurses and four neurophysiologists...
January 25, 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/27903013/isoflurane-associated-mydriasis-mimicking-blown-pupils-in-a-patient-treated-in-a-neurointensive-care-unit
#13
Eva Magdalena Korf, Volker Martin Tronnier, Jan Gliemroth, Jan Nils Küchler
We report a misinterpretation of bilateral mydriasis as blown pupils related to elevated intracranial pressure (ICP) under volatile sedation with isoflurane (Anesthetic Conserving Device [AnaConDa], Hudson RCI, Uppland Vasby, Sweden) in a 59-year-old patient with a severe traumatic brain injury with frontal contusion. The patient showed bilateral mydriasis and a missing light reflex 8 hours after changing sedation from intravenous treatment with midazolam and esketamine to volatile administration of isoflurane...
November 30, 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/27871507/use-of-gabaergic-sedatives-after-subarachnoid-hemorrhage-is-associated-with-worse-outcome-preliminary-findings
#14
Daniel N Hertle, Christopher Beynon, Jan O Neumann, Edgar Santos, Renan Sánchez-Porras, Andreas W Unterberg, Oliver W Sakowitz
STUDY OBJECTIVE: Recent experimental evidence identified GABAergic sedation as a possible cause for deprived neuroregeneration and poor outcome after acute brain injury. Patients with aneurysmal subarachnoid hemorrhage are often sedated, and GABAergic sedation, such as midazolam and propofol, is commonly used. DESIGN: Retrospective cohort study based on a prospectively established database. SETTING: Single-center neurointensive care unit. PATIENTS: Twenty-nine patients after subarachnoid hemorrhage...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27748614/using-personality-traits-to-construct-linear-growth-models-of-mental-health-in-family-members-of-individuals-with-severe-brain-injury
#15
Michael Trujillo, Paul B Perrin, Karoline Doser, Anne Norup
Objective: No studies have examined the impact of personality traits on mental health among caregivers of individuals with severe brain injury. Therefore, the purpose of the current study was to construct linear growth models to examine whether the personality traits of family members of individuals with severe brain injury could predict the trajectories of their own mental health-related quality of life (HRQoL), anxiety, and depression beginning in a neurointensive care unit through 1 year after injury. Method: Danish family members of individuals with severe brain injury (n = 52) completed the Short Form-36 assessing mental HRQoL (vitality, social functioning, role limitations-emotional, mental health), anxiety, and depression across 5 time points during the 1st year after injury...
October 17, 2016: Rehabilitation Psychology
https://www.readbyqxmd.com/read/27716379/spinal-cord-injury-is-monitoring-from-the-injury-site-the-future
#16
Samira Saadoun, Marios C Papadopoulos
This paper challenges the current management of acute traumatic spinal cord injury based on our experience with monitoring from the injury site in the neurointensive care unit. We argue that the concept of bony decompression is inadequate. The concept of optimum spinal cord perfusion pressure, which differs between patients, is introduced. Such variability suggests individualized patient treatment. Failing to optimize spinal cord perfusion limits the entry of systemically administered drugs into the injured cord...
October 5, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27692109/age-related-injury-patterns-in-spanish-trauma-icu-patients-results-from-the-retrauci
#17
Juan Antonio Llompart-Pou, Mario Chico-Fernández, Marcelino Sánchez-Casado, Fermín Alberdi-Odriozola, Francisco Guerrero-López, María Dolores Mayor-García, Javier González-Robledo, María Ángeles Ballesteros-Sanz, Rubén Herrán-Monge, Rafael León-López, Lucía López-Amor, Ana Bueno-González
BACKGROUND: Injury patterns may differ in trauma patients when age is considered. This information is relevant in the management of trauma patients and for planning preventive measures. METHODS: We included in the study all patients admitted for traumatic disease in the participating ICUs from November 23(rd), 2012 to July 31(st), 2015 with complete records. Data on epidemiology, injury patterns, severity scores, acute management, resources utilisation and outcome were recorded and compared in the following groups of age: ≤55years (young adults), 56-65 years (adults), 66-75 years (elderly), >75years (very elderly)...
September 2016: Injury
https://www.readbyqxmd.com/read/27619228/neurocritical-care-education-during-residency-opinions-neuron-study
#18
David P Lerner, Jennifer Kim, Saef Izzy
BACKGROUND: The American Academy of Neurology (AAN) has established a core curriculum of topics for residency training in neurocritical care. At present there is limited data evaluating neurology residency education within the neurological intensive care unit. This study evaluates learner concerns with the neurological intensive care unit. METHODS: The Communication Committee and Resident & Fellow Taskforce within the Neurocritical Care Society (NCS) developed an online survey that consisted of 20 selection and free-text based questions...
September 12, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27524453/the-role-of-the-neurointensive-care-nursery-for-neonatal-encephalopathy
#19
REVIEW
Hannah C Glass, David H Rowitch
Neonatal encephalopathy due to intrapartum events is estimated at 1 to 2 per 1000 live births in high-income countries. Outcomes have improved over the past decade due to implementation of therapeutic hypothermia, the only clinically available neuroprotective strategy for hypoxic-ischemic encephalopathy. Neonatal encephalopathy is the most common condition treated within a neonatal neurocritical care unit. Neonates with encephalopathy benefit from a neurocritical care approach due to prevention of secondary brain injury through attention to basic physiology, earlier recognition and treatment of neurologic complications, consistent management using guidelines and protocols, and use of optimized teams at dedicated referral centers...
September 2016: Clinics in Perinatology
https://www.readbyqxmd.com/read/27521200/neuromuscular-disease-in%C3%A2-the-neurointensive-care-unit
#20
REVIEW
Veronica Crespo, Michael L Luke James
Neuromuscular diseases are syndromic disorders that affect nerve, muscle, and/or neuromuscular junction. Knowledge about the management of these diseases is required for anesthesiologists, because these may frequently be encountered in the intensive care unit, operating room, and other settings. The challenges and advances in management for some of the neuromuscular diseases most commonly encountered in the operating room and neurointensive care unit are reviewed.
September 2016: Anesthesiology Clinics
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