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Intracerebral bleed

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5 papers 0 to 25 followers
By Jason Mann No BS pulmonary critical care fellow
https://www.readbyqxmd.com/read/27737684/management-of-delayed-cerebral-ischemia-after-subarachnoid-hemorrhage
#1
Charles L Francoeur, Stephan A Mayer
For patients who survive the initial bleeding event of a ruptured brain aneurysm, delayed cerebral ischemia (DCI) is one of the most important causes of mortality and poor neurological outcome. New insights in the last decade have led to an important paradigm shift in the understanding of DCI pathogenesis. Large-vessel cerebral vasospasm has been challenged as the sole causal mechanism; new hypotheses now focus on the early brain injury, microcirculatory dysfunction, impaired autoregulation, and spreading depolarization...
October 14, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27276234/intensive-blood-pressure-lowering-in-patients-with-acute-cerebral-hemorrhage
#2
RANDOMIZED CONTROLLED TRIAL
Adnan I Qureshi, Yuko Y Palesch, William G Barsan, Daniel F Hanley, Chung Y Hsu, Renee L Martin, Claudia S Moy, Robert Silbergleit, Thorsten Steiner, Jose I Suarez, Kazunori Toyoda, Yongjun Wang, Haruko Yamamoto, Byung-Woo Yoon
Background Limited data are available to guide the choice of a target for the systolic blood-pressure level when treating acute hypertensive response in patients with intracerebral hemorrhage. Methods We randomly assigned eligible participants with intracerebral hemorrhage (volume, <60 cm(3)) and a Glasgow Coma Scale (GCS) score of 5 or more (on a scale from 3 to 15, with lower scores indicating worse condition) to a systolic blood-pressure target of 110 to 139 mm Hg (intensive treatment) or a target of 140 to 179 mm Hg (standard treatment) in order to test the superiority of intensive reduction of systolic blood pressure to standard reduction; intravenous nicardipine to lower blood pressure was administered within 4...
September 15, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/26022637/guidelines-for-the-management-of-spontaneous-intracerebral-hemorrhage-a-guideline-for-healthcare-professionals-from-the-american-heart-association-american-stroke-association
#3
J Claude Hemphill, Steven M Greenberg, Craig S Anderson, Kyra Becker, Bernard R Bendok, Mary Cushman, Gordon L Fung, Joshua N Goldstein, R Loch Macdonald, Pamela H Mitchell, Phillip A Scott, Magdy H Selim, Daniel Woo
PURPOSE: The aim of this guideline is to present current and comprehensive recommendations for the diagnosis and treatment of spontaneous intracerebral hemorrhage. METHODS: A formal literature search of PubMed was performed through the end of August 2013. The writing committee met by teleconference to discuss narrative text and recommendations. Recommendations follow the American Heart Association/American Stroke Association methods of classifying the level of certainty of the treatment effect and the class of evidence...
July 2015: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/26324162/decompressive-hemicraniectomy-in-acute-neurological-diseases
#4
Angela Crudele, Syed Omar Shah, Barak Bar
Increased intracranial pressure (ICP) secondary to severe brain injury is common. Increased ICP is commonly encountered in malignant middle cerebral artery ischemic stroke, traumatic brain injury, subarachnoid hemorrhage, and intracerebral hemorrhage. Multiple interventions-both medical and surgical-exist to manage increased ICP. Medical management is used as first-line therapy; however, it is not always effective and is associated with significant risks. Decompressive hemicraniectomy is a surgical option to reduce ICP, increase cerebral compliance, and increase cerebral blood perfusion when medical management becomes insufficient...
October 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/26261773/steps-to-consider-in-the-approach-and-management-of-critically-ill-patient-with-spontaneous-intracerebral-hemorrhage
#5
REVIEW
Daniel Agustin Godoy, Gustavo Rene PiƱero, Patricia Koller, Luca Masotti, Mario Di Napoli
Spontaneous intracerebral hemorrhage is a type of stroke associated with poor outcomes. Mortality is elevated, especially in the acute phase. From a pathophysiological point of view the bleeding must traverse different stages dominated by the possibility of re-bleeding, edema, intracranial hypertension, inflammation and neurotoxicity due to blood degradation products, mainly hemoglobin and thrombin. Neurological deterioration and death are common in early hours, so it is a true neurological-neurosurgical emergency...
August 4, 2015: World Journal of Critical Care Medicine
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