2,363 results match your criteria Neurocritical Care[Journal]


Direct enhancement of readiness for wartime critical specialties by civilian-military partnerships for neurosurgical care: residency training and beyond.

Authors:

Neurosurg Focus 2018 Dec;45(6):E17

Military neurosurgery has played an integral role in the development and innovation of neurosurgery and neurocritical care in treating battlefield injuries. It is of paramount importance to continue to train and prepare the next generation of military neurosurgeons. For the Army, this is currently primarily achieved through the military neurosurgery residency at the National Capital Consortium and through full-time out-service positions at the Veterans Affairs-Department of Defense partnerships with the University of Florida, the University of Texas-San Antonio, and Baylor University. Read More

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December 2018

Consciousness in Neurocritical Care Cohort Study Using fMRI and EEG (CONNECT-ME): Protocol for a Longitudinal Prospective Study and a Tertiary Clinical Care Service.

Front Neurol 2018 27;9:1012. Epub 2018 Nov 27.

Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.

To facilitate individualized assessment of unresponsive patients in the intensive care unit for signs of preserved consciousness after acute brain injury. Physicians and neuroscientists are increasingly recognizing a disturbing dilemma: Brain-injured patients who appear entirely unresponsive at the bedside may show signs of covert consciousness when examined by functional MRI (fMRI) or electroencephalography (EEG). According to a recent meta-analysis, roughly 15% of behaviorally unresponsive brain-injured patients can participate in mental tasks by modifying their brain activity during EEG- or fMRI-based paradigms, suggesting that they are conscious and misdiagnosed. Read More

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November 2018

Regional Cerebral Oximetry as an Indicator of Acute Brain Injury in Adults Undergoing Veno-Arterial Extracorporeal Membrane Oxygenation-A Prospective Pilot Study.

Front Neurol 2018 23;9:993. Epub 2018 Nov 23.

Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, MD, United States.

Regional cerebral oxygen saturation (rScO2) measured by near-infrared spectroscopy (NIRS) can be used to monitor brain oxygenation in extracorporeal membrane oxygenation (ECMO). ECMO patients that develop acute brain injuries (ABIs) are observed to have worse outcomes. We evaluated the association between rScO2 and ABI in venoarterial (VA) ECMO patients. Read More

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November 2018

The Best of the Old With Promise of the New: The Format of the Annual Meeting of the Society for Neuroscience in Anesthesiology and Critical Care is Changing.

Authors:
Martin Smith

J Neurosurg Anesthesiol 2019 Jan;31(1)

Department of Neuroanesthesia and Neurocritical Care, The National Hospital for Neurosurgery and Neurology, University College London Hospitals, London, UK.

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January 2019

Conventional and quantitative EEG in status epilepticus.

Seizure 2018 Oct 6. Epub 2018 Oct 6.

Departments of Neurology and Pediatrics, The Children's Hospital of Philadelphia and the University of Pennsylvania; 3501 Civic Center Blvd. Philadelphia, PA, 19104.

Purpose: To summarize the use of continuous electroencephalographic monitoring (cEEG) in the diagnosis and management of pediatric convulsive status epilepticus (CSE) and subsequent non-convulsive seizures (NCS) with a focus on available guidelines and infrastructure. In addition, we provide an overview of quantitative EEG (QEEG) for the identification of NCS in critically ill children.

Methods: We performed a review of the medical literature on the use of cEEG and QEEG in pediatric CSE. Read More

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October 2018

Trajectories of early secondary insults correlate to outcomes of traumatic brain injury: results from a large, single centre, observational study.

BMC Emerg Med 2018 Dec 5;18(1):52. Epub 2018 Dec 5.

School of Medicine and Surgery, University of Milan-Bicocca, Via Cadore 48, 20900, Monza, MB, Italy.

Background: Secondary insults (SI), such as hypotension, hypoxia, and intracranial hypertension frequently occur after traumatic brain injury (TBI), and have a strong impact on patients' clinical outcomes. The aim of this study is to examine the trajectories of SI from the early phase of injury in the prehospital setting to hospital admission in a cohort of TBI patients.

Methods: This is a retrospective, observational, single centre study on consecutive patients admitted from 1997 to 2016 to the Neuro Intensive Care Unit (NICU) at San Gerardo Hospital, in Monza, Italy. Read More

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December 2018
1 Read

Paroxysmal sympathetic hyperactivity due to fourth ventricular tumor resection resulting in cerebrovascular constriction syndrome.

Neurol India 2018 Nov-Dec;66(6):1821-1822

Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.

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December 2018
1 Read

Unintended Pregnancies and Failure to Prevent Them: Pakistan's Dilemma.

J Coll Physicians Surg Pak 2018 Dec;28(12):980

Department of Neurosurgery and Neurocritical Care, Thomas Jefferson University, PA, USA.

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December 2018

Neurocritical Care Coding for Neurologists.

Continuum (Minneap Minn) 2018 Dec;24(6):1800-1809

Coding specifies the work performed when providing patient care. Critical care services mostly use code 99291, and other codes specify additional time and procedures. Current Procedural Terminology defines critically ill as "a high probability of imminent or life-threatening deterioration in the patient's condition," a condition necessary for use of the critical care code. Read More

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December 2018
2 Reads

End-of-life Considerations and Shared Decision Making in Neurocritical Care.

Continuum (Minneap Minn) 2018 Dec;24(6):1794-1799

The goal of shared decision making in the neurocritical care setting is to form plans of care that are consistent with best medical practice and are respectful of the patient's values. Close cooperation and meaningful interaction must be achieved with family members so that the patient's "person can emerge" through discussions. This article highlights several caveats that can subvert this complex process, including the cognitive biases that affect both clinicians and surrogates. Read More

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December 2018
1 Read

Multimodality Monitoring in the Neurocritical Care Unit.

Continuum (Minneap Minn) 2018 Dec;24(6):1776-1788

Purpose Of Review: This article focuses on the multiple neuromonitoring devices that can be used to collect bedside data in the neurocritical care unit and the methodology to integrate them into a multimodality monitoring system. The article describes how to apply the collected data to appreciate the physiologic changes and develop therapeutic approaches to prevent secondary injury.

Recent Findings: The neurologic examination has served as the primary monitor for secondary brain injury in patients admitted to the neurocritical care unit. Read More

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December 2018
1 Read

Management of Stroke in the Neurocritical Care Unit.

Continuum (Minneap Minn) 2018 Dec;24(6):1658-1682

Purpose Of Review: This article provides updated information regarding the diagnosis and treatment (specifically critical care management) of acute ischemic stroke. This article also discusses the increased use of thrombolysis and thrombectomy in clinical practice.

Recent Findings: Stroke is the leading cause of disability in the United States. Read More

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December 2018
1 Read

Subarachnoid Hemorrhage.

Continuum (Minneap Minn) 2018 Dec;24(6):1623-1657

Purpose Of Review: This article reviews the epidemiology, clinical presentation, diagnosis, and management of patients with aneurysmal subarachnoid hemorrhage (SAH). SAH is a type of hemorrhagic stroke and is a neurologic emergency with substantial morbidity and mortality. This article reviews the most common and potentially life-threatening neurologic and medical complications to promote their early recognition and prevent secondary brain injury. Read More

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December 2018
2 Reads

Cerebral Edema and Elevated Intracranial Pressure.

Authors:
Matthew A Koenig

Continuum (Minneap Minn) 2018 Dec;24(6):1588-1602

Purpose Of Review: This article reviews the management of cerebral edema, elevated intracranial pressure (ICP), and cerebral herniation syndromes in neurocritical care.

Recent Findings: While corticosteroids may be effective in reducing vasogenic edema around brain tumors, they are contraindicated in traumatic cerebral edema. Mannitol and hypertonic saline use should be tailored to patient characteristics including intravascular volume status. Read More

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December 2018
1 Read

Management Strategies for Intracranial Pressure Crises in Subarachnoid Hemorrhage.

J Intensive Care Med 2018 Dec 4:885066618813073. Epub 2018 Dec 4.

4 Department of Neurology, Division of Neuroendovascular Surgery and Neurocritical Care, Rutgers University-Robert Wood Johnson Medical School, New Brunswick, NJ, USA.

Objectives: Standard management strategies for lowering intracranial pressure (ICP) in traumatic brain injury has been well-studied, but the use of lesser known interventions for ICP in subarachnoid hemorrhage (SAH) remains elusive. Searches were performed in PubMed and EBSCO Host to identify best available evidence for evaluation and management of medically refractory ICP in SAH. The role of standard management strategies such as head elevation, hyperventilation, mannitol and hypertonic saline as well as lesser known management such as sodium bicarbonate, indomethacin, tromethamine, decompressive craniectomy, decompressive laparotomy, hypothermia, and barbiturate coma are reviewed. Read More

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December 2018
1 Read

A Comparison of Satisfaction With Life and the Glasgow Outcome Scale-Extended After Traumatic Brain Injury: An Analysis of the TRACK-TBI Pilot Study.

J Head Trauma Rehabil 2018 Nov 28. Epub 2018 Nov 28.

Department of Emergency Medicine (Drs Kreitzer and Adeoye), Division of Neurocritical Care (Drs Kreitzer and Adeoye), and Department of Neurosurgery (Dr Adeoye), University of Cincinnati, Cincinnati, Ohio; Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee (Ms Hart and Dr Lindsell); Department of Neurological Surgery, University of California, San Francisco (Drs Manley and Yue); Department of Rehabilitation Medicine, University of Washington, Seattle (Dr Dikmen); Department of Emergency Medicine, and Department of Neurology, Division of Neurocritical Care Emory University, Atlanta, Georgia (Dr Ratcliff).

Objective: To evaluate the relationship between satisfaction with life (SWL) and functional outcome after traumatic brain injury (TBI).

Setting And Participants: The Transforming Research and Clinical Knowledge in Traumatic Brain Injury Pilot study (TRACK-TBI Pilot) enrolled patients at 3 US Level I trauma centers within 24 hours of TBI.

Design: Patients were grouped by outcome measure concordance (good-recovery/good-satisfaction, impaired-recovery/impaired-satisfaction) and discordance (good-recovery/impaired-satisfaction, impaired-recovery/good-satisfaction). Read More

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November 2018

Ketamine Infusion Used to Successfully Control Refractory Status Epilepticus in a Pregnant Patient.

Case Rep Neurol Med 2018 25;2018:3041279. Epub 2018 Oct 25.

Department of Neurocritical Care, Ochsner Health System, New Orleans, LA, USA.

The management of SE during pregnancy is especially challenging to the treating physician. While antiepileptic medications might cause teratogenicity, SE can have significant morbidity and mortality on both the mother and the developing fetus. This case report demonstrated the successful use of ketamine infusion in the management of RSE in pregnancy without affecting the immediate outcome of pregnancy. Read More

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October 2018

Evaluation of Hospital-Wide Readmission Risk Calculator to Predict 30-Day Readmission in Neurocritical Care Patients.

J Neurosci Nurs 2018 Nov 27. Epub 2018 Nov 27.

Questions or comments about this article may be directed to Jane R. von Gaudecker, PhD RN, at She is an Assistant Professor, Indiana University School of Nursing, Indianapolis, IN.

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November 2018

Evaluation of Hospital-wide Readmission Risk Calculator to Predict 30-Day Readmission in Neurocritical Care Patients.

J Neurosci Nurs 2018 Nov 27. Epub 2018 Nov 27.

Questions or comments about this article may be directed to Sarah Peacock, MSN ACNP-BC, at She is an Acute Care Nurse Practitioner, Department of Critical Care Medicine, Mayo Clinic, Jacksonville, FL. Jason Siegel, MD, Departments of Critical Care and Neurology, Mayo Clinic, Jacksonville, FL. Emily Harmer, ARNP, Department of Critical Care, Mayo Clinic, Jacksonville, FL. David Alejos, MD, Department of Internal Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, New York, NY. W. David Freeman, MD, Departments of Critical Care, Neurology, and Neurosurgery, Mayo Clinic, Jacksonville, FL.

Background And Purpose: Thirty-day hospital readmissions have been shown to be a measure of quality and result in higher mortality and increased costs. Readmissions are a target for hospitals and payers; thus, several centers have developed predictive readmission scores to identify high-risk patients. The purpose of this study was to evaluate the current hospital-wide readmission risk calculator and the ability of this tool to predict 30-day readmissions in the neurocritical care population. Read More

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November 2018

Neurocritical Care Management of Hepatic Encephalopathy and Coma in Liver Failure.

Semin Respir Crit Care Med 2018 Oct 28;39(5):523-537. Epub 2018 Nov 28.

Liver Failure Group, Institute for Liver and Digestive Health, University College London, London, United Kingdom.

Hepatic encephalopathy (HE) is a severe complication of liver disease, describing a spectrum of neurological and psychiatric abnormalities ranging from subclinical alterations to coma. HE is the leading cause for hospital readmission, intensive care treatment, and mortality in patients with chronic liver disease. The complex and multifaceted pathogenesis is not yet fully understood, but hypotheses focus on ammonia and systemic inflammation, which are the main targets for currently available therapies in clinical practice. Read More

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October 2018

The Feasibility, Safety and Effectiveness of a Ketogenic Diet for Refractory Status Epilepticus in Adults in the Intensive Care Unit.

Neurocrit Care 2018 Nov 27. Epub 2018 Nov 27.

Epilepsy Center, Hauenstein Neurosciences Mercy Health Saint Mary's, Grand Rapids, MI, USA.

Background: Status, refractory status and super refractory status epilepticus are common neurologic emergencies. The objective of this study is to investigate the feasibility, safety and effectiveness of a ketogenic diet (KD) for refractory status epilepticus (RSE) in adults in the intensive care unit (ICU).

Methods: We performed a retrospective, single-center study of patients between ages 18 and 80 years with RSE treated with a KD treatment algorithm from November 2016 through April 2018. Read More

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November 2018
1 Read

Cardiac Dysfunction in Neurocritical Care: An Autonomic Perspective.

Neurocrit Care 2018 Nov 27. Epub 2018 Nov 27.

Department of Neurology, Division of Neurocritical care, Wayne State University School of Medicine, Detroit, MI, USA.

A number of neurologic disorders can cause cardiac dysfunction by involving the conductive system and contractile apparatus of the heart. This is especially prominent in the neurocritical care setting where the spectrum of cardiac dysfunction due to acute neurologic injury ranges from trivial and isolated electrocardiographic changes to malignant arrhythmias and sudden death (Table 1). The mechanism of these cardiac complications is complex and not fully understood. Read More

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November 2018
3 Reads

Systemic Antimicrobial Prophylaxis and Antimicrobial-Coated External Ventricular Drain Catheters for Preventing Ventriculostomy-Related Infections: A Meta-Analysis of 5242 Cases.

Neurosurgery 2018 Nov 26. Epub 2018 Nov 26.

Department of Neurosurgery, Ronald Regan UCLA Medical Center, Los Angeles, California.

Background: External ventricular drain (EVD) placement is essential for the management of many neurocritical care patients. However, ventriculostomy-related infection (VRI) is a serious complication, and there remains no well-established protocol guiding use of perioperative or extended antibiotic prophylaxis to minimize risk of VRI.

Objective: To analyze published evidence on the efficacy of extended prophylactic antimicrobial therapy and antibiotic-coated external ventricular drains (ac-EVDs) in reducing VRI incidence. Read More

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November 2018
7 Reads

Twenty-Five Years of Intracranial Pressure Monitoring After Severe Traumatic Brain Injury: A Retrospective, Single-Center Analysis.

Neurosurgery 2018 Nov 23. Epub 2018 Nov 23.

Brain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom.

Background: Intracranial pressure (ICP) is a clinically important variable after severe traumatic brain injury (TBI) and has been monitored, along with clinical outcome, for over 25 yr in Addenbrooke's hospital, Cambridge, United Kingdom. This time period has also seen changes in management strategies with the implementation of protocolled specialist neurocritical care, expansion of neuromonitoring techniques, and adjustments of clinical treatment targets.

Objective: To describe the changes in intracranial monitoring variables over the past 25 yr. Read More

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November 2018
1 Read

Prognostic Value of Tissue Oxygen Monitoring and Regional Cerebral Oxygen Saturation Monitoring and Their Correlation in Neurological Patients With Sepsis: A Preliminary, Prospective, Observational Study.

J Neurosurg Anesthesiol 2018 Nov 20. Epub 2018 Nov 20.

Department of Neuroanaesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India.

Background: There is paucity of literature on the prognostic value of tissue oxygen saturation (StO2) and regional cerebral oxygen saturation (rSO2) in neurological patients with sepsis. In this preliminary study, we investigated the prognostic value of StO2 and rSO2 in a group of neurological patients and correlated StO2 and rSO2 with hemodynamic and metabolic parameters.

Materials And Methods: This preliminary, prospective observational study was conducted in 45 adult neurological patients admitted to intensive care unit. Read More

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November 2018
7 Reads
2.990 Impact Factor

Lacosamide versus phenytoin for the prevention of early post traumatic seizures.

J Crit Care 2018 Nov 14;50:50-53. Epub 2018 Nov 14.

Neurocritical Care, A.T. Still University, School of Osteopathic Medicine, 111 E. Dunlap Ave #1-279, Phoenix, AZ 85020, United States.

Purpose: To compare the efficacy and safety of lacosamide versus phenytoin for seizure prophylaxis following TBI.

Materials And Methods: All TBI patients who received prophylaxis with either phenytoin or lacosamide were retrospectively identified. The incidence of seizures within the first 7 days of injury were compared along with adverse effects requiring drug discontinuation. Read More

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November 2018
2 Reads

Depressive symptom prevalence after intracerebral hemorrhage: a multi-center study.

J Patient Rep Outcomes 2018 Nov 23;2(1):55. Epub 2018 Nov 23.

Institute for Public Health and Medicine, Hauenstein Neurosciences, Northwestern University, 233 Erie St, Chicago, Il 60611, USA.

Introduction: Depressive symptoms in patients with intracerebral hemorrhage (ICH) are common and are associated with worse outcomes. It is not well described how often depressive symptoms are ascertained and treated in large unselected cohorts of patients, and whether depressive symptoms would be a potential target for improving outcomes.

Methods: Data were electronically retrieved from a multi-center EHR repository in Chicago, IL, from 2006 to 2012 ("multicenter cohort"). Read More

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November 2018
3 Reads

Low Risk Monitoring in Neurocritical Care.

Front Neurol 2018 6;9:938. Epub 2018 Nov 6.

eHealth Center, Westchester Medical Center Health Network, Valhalla, NY, United States.

Patients are admitted to Intensive care units (ICUs) either because they need close monitoring despite a low risk of hospital mortality (LRM group) or to receive ICU specific active treatments (AT group). The characteristics and differential outcomes of LRM patients vs. AT patients in Neurocritical Care Units are poorly understood. Read More

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November 2018
4 Reads

[(3)Neurocritical Care for Traumatic Brain Injury].

Authors:
Hitoshi Kobata

No Shinkei Geka 2018 Nov;46(11):1027-1039

Osaka Mishima Emergency Critical Care Center.

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November 2018
1 Read

Patient characteristics and critical care workflow affect paging frequency in neurocritical care.

J Clin Neurosci 2018 Nov 16. Epub 2018 Nov 16.

Department of Anesthesiology and Pain Medicine, Harborview Medical Center, University of Washington, Seattle, WA, United States.

Indicator of response urgency (page tag), paging domains, distribution of pages by time of the day, and factors associated with neurocritical care paging remain elusive and were examined in this study. We examined the association between patient, neurocritical care workflow characteristics, and paging domains on frequency of paging using Student's t-test, Chi-square test, and analysis of covariance. A total of 1852 patients generated 36,472 pages. Read More

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November 2018
1 Read

Cushing response-based warning system for intensive care of brain-injured patients.

Clin Neurophysiol 2018 Dec 21;129(12):2602-2612. Epub 2018 Sep 21.

Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan. Electronic address:

Objective: Cushing response (CR) is categorized. Wavelet transform (WT) and decision tree (DT) are utilized to analyze physiological signals from neurocritical patients. A warning model is built for recognition of CR, real-time evaluation of intracranial condition and prediction of neurological outcome. Read More

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December 2018
1 Read

Predictive value of iron parameters in neurocritically ill patients.

Brain Behav 2018 Nov 19:e01163. Epub 2018 Nov 19.

Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, China.

Background: Iron, an essential mineral for human body, has the potential to cause toxicity at high levels. Previous studies have shown inconsistent predictive value of iron parameters in critically ill patients. Thus, we aimed to evaluate the performance of iron parameters in outcome prediction of neurocritically ill patients. Read More

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November 2018
2 Reads

Prolonged monitoring of cerebral blood flow and autoregulation with diffuse correlation spectroscopy in neurocritical care patients.

Neurophotonics 2018 Oct 13;5(4):045005. Epub 2018 Nov 13.

Massachusetts General Hospital, Department of Neurology, Boston, Massachusetts, United States.

Monitoring of cerebral blood flow (CBF) and autoregulation are essential components of neurocritical care, but continuous noninvasive methods for CBF monitoring are lacking. Diffuse correlation spectroscopy (DCS) is a noninvasive diffuse optical modality that measures a CBF index ( ) in the cortex microvasculature by monitoring the rapid fluctuations of near-infrared light diffusing through moving red blood cells. We tested the feasibility of monitoring with DCS in at-risk patients in the Neurosciences Intensive Care Unit. Read More

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October 2018
5 Reads

Immunotherapy for anti-NMDA receptor encephalitis: Experience from a single center in Taiwan.

Pediatr Neonatol 2018 Oct 31. Epub 2018 Oct 31.

Chang Gung Children's Hospital Study Group for Children with Encephalitis/Encephalopathy Related Status Epilepticus and Epilepsy (CHEESE), Taoyuan, Taiwan.

Background: Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is an anti-neuronal antibody-mediated inflammatory brain disease that causes severe psychiatric and neurological deficits in previously healthy patients. The aims of this study were to demonstrate the clinical characteristics of patients diagnosed with anti-NMDA receptor encephalitis and to compare the different treatment strategies among these patients.

Methods: Patients presenting with newly acquired psychiatric and/or neurological deficits were studied retrospectively from 2009 to 2017. Read More

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October 2018
7 Reads

Improving Ventriculostomy Management: Risk and Cost Reduction Through a Multidisciplinary Approach.

World Neurosurg 2018 Nov 14. Epub 2018 Nov 14.

Department of Neurosurgery, University of Illinois Hospital & Health Science System, Chicago, Illinois, USA.

Objective: Infection is a life-threatening complication of ventriculostomy. The purpose of this quality improvement project was to develop a cost-effective, evidence-based intervention to reduce ventriculostomy-associated infection (VAI) rates.

Methods: In this retrospective study, patients undergoing ventriculostomy insertion between June 2008 and December 2016 were identified, and charts were reviewed. Read More

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November 2018
8 Reads
2.420 Impact Factor

Natural Cerebral Aneurysm and Spontaneous Subarachnoid Hemorrhage in Mammals Other Than Man: Is there a Scope for Comparative Medicine?

World Neurosurg 2018 Nov 14. Epub 2018 Nov 14.

Neurocritical Care Unit, Department of Neurosurgery, University Hospital Zurich, CH-8091 Zurich, Switzerland.

Background: Concepts which showed substantial efficacy in animal models of subarachnoid hemorrhage (SAH), often failed improve outcome in humans with aneurysmal SAH. The concept of "comparative medicine", an open-minded comparison across species, might offer an alternative to the "constructed" animal models' approach. Naturally occurring diseases in animals might bear more similarity to human diseases than models. Read More

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November 2018
4 Reads

Current Practices of Intraventricular Antibiotic Therapy in the Treatment of Meningitis and Ventriculitis: Results from a Multicenter Retrospective Cohort Study.

Neurocrit Care 2018 Nov 16. Epub 2018 Nov 16.

Departments of Neurology and Anesthesiology & Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, USA.

Background: Central nervous system (CNS) infections are particularly prevalent in the adult neurocritical care patient population and are associated with significant morbidity and mortality. Factors relevant to the nature of CNS infections pose significant challenges to clinicians treating afflicted patients. Intraventricular (IVT) administration of antibiotics may offer several benefits over systemic therapy; however, the outcomes and current practices of such treatments are poorly described in the literature. Read More

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November 2018
11 Reads

Effect of IV glyburide on adjudicated edema endpoints in the GAMES-RP Trial.

Neurology 2018 Dec 16;91(23):e2163-e2169. Epub 2018 Nov 16.

From the Department of Neurology and Center for Genomic Medicine (W.T.K.), and Department of Radiology, Division of Neuroradiology (J.M.R.), Massachusetts General Hospital, Boston; Divisions of Stroke, Cerebrovascular and Critical Care Neurology (M.B.B.), Brigham & Women's Hospital, Boston, MA; Department of Neuroradiology (R.v.K.), Universitätsklinikum Carl Gustav Carus, Dresden, Germany; Calgary Stroke Program (A.M.D.), Department of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, University of Calgary, Canada; Department of Public Health Sciences (J.J.E.), Medical University of South Carolina, Charleston; Department of Neurology (H.E.H.), Oregon Health Sciences University, Portland; Department of Neurology (B.J.M.), University of Pittsburgh, PA; Department of Neurosurgery (J.M.S.), University of Maryland School of Medicine, Baltimore; and Division of Neurocritical Care and Emergency Neurology (K.N.S.), Yale New Haven Hospital, CT.

Objective: In this secondary analysis of the Glyburide Advantage in Malignant Edema and Stroke (GAMES-RP) Trial, we report the effect of IV glyburide on adjudicated, edema-related endpoints.

Methods: Blinded adjudicators assigned designations for hemorrhagic transformation, neurologic deterioration, malignant edema, and edema-related death to patients from the GAMES-RP phase II randomized controlled trial of IV glyburide for large hemispheric infarct. Rates of these endpoints were compared between treatment arms in the per-protocol sample. Read More

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December 2018
3 Reads

Author Correction: Neuroimmune disorders of the central nervous system in children in the molecular era.

Nat Rev Neurol 2018 Dec;14(12):749

Department of Neurology and Pediatric Multiple Sclerosis Clinic, Children's Hospital of Philadelphia, Philadelphia, PA, USA.

In the original version of this Review published online and in print, the contribution of attendees of the International Neuroimmune Meeting to the content of the Review was not acknowledged. The author list has been corrected in the PDF and HTML versions of this article to acknowledge that the Review was written on behalf of attendees of the International Neuroimmune Meeting, and the names of the attendees have been added to the HTML version. Read More

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December 2018

Hypertension Is Associated with White Matter Disruption in Apparently Healthy Middle-Aged Individuals.

AJNR Am J Neuroradiol 2018 Nov 15. Epub 2018 Nov 15.

Department of Anesthesiology and Critical Care Medicine (P.A.N.), Neurosciences Critical Care.

Background And Purpose: Traditional cardiovascular risk factors have been associated with white matter disease. Because hypertension results in vascular stiffness and impaired cerebral perfusion, we hypothesized that it would be the most relevant risk factor for microstructural white matter disruption in apparently healthy middle-aged individuals with a family history of early-onset coronary artery disease.

Materials And Methods: This was a cross-sectional analysis of participants in the Genetic Study of Atherosclerosis Risk with DTI. Read More

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November 2018
3 Reads

Optimizing Neurocritical Care Follow-Up Through the Integration of Neuropsychology.

Pediatr Neurol 2018 Dec 18;89:58-62. Epub 2018 Sep 18.

Doernbecher Children's Hospital/Oregon Health and Science University, Division of Child Neurology, Portland, Oregon.

Background: Pediatric critical care survivors often suffer persisting multisystem health problems and are left with treatment needs that go unmet due to limits in current care models. We proposed that integration of neuropsychology into neurocritical care follow-up provides incremental benefit to the identification and treatment of persisting complications and reduction in co-morbidities.

Basic Procedures: The aims of this study were three-fold. Read More

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December 2018
3 Reads

Cerebral Perfusion Pressure Targets in Traumatic Brain Injury: The "Fuzzy" Spots Above Optimal Cerebral Perfusion Pressure.

Can J Neurol Sci 2018 Nov;45(6):721-722

1Department of Surgery,Rady Faculty of Health Sciences,University of Manitoba,Winnipeg,Manitoba,Canada.

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November 2018
4 Reads

Endovascular aspiration of clot in a 3-year-old child with embolic infarct of right middle cerebral artery.

Saudi J Anaesth 2018 Oct-Dec;12(4):643-645

Department of Neuroanesthesia and neurocritical care, Kokilaben Ambani Hospital, Mumbai, Maharashtra, India.

Stroke in children is common and is associated with long-term morbidity. The incidence of stroke is 13/100,000 in children above 1 month, with higher incidences in neonates and premature infants. It has to be differentiated from other diseases which have a similar presentation. Read More

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November 2018
1 Read

Low-chloride versus high-chloride hypertonic solution for the treatment of subarachnoid hemorrhage-related complications (The ACETatE trial): study protocol for a pilot randomized controlled trial.

Trials 2018 Nov 14;19(1):628. Epub 2018 Nov 14.

Department of Critical Care Medicine, Mayo Clinic, Phoenix, AZ, 85054, USA.

Background: Aneurysmal subarachnoid hemorrhage (aSAH) is a life-threatening condition that results from a ruptured cerebral vessel. Cerebral edema and vasospasm are common complications and frequently require treatment with hypertonic solutions, in particular hypertonic sodium chloride (NaCl). We have previously shown that hyperchloremia in patients with aSAH given hypertonic NaCl is associated with the development of acute kidney injury (AKI), which leads to higher morbidity and mortality. Read More

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November 2018
5 Reads

Clinical Q & A: Translating Therapeutic Temperature Management from Theory to Practice.

Ther Hypothermia Temp Manag 2018 Nov 14. Epub 2018 Nov 14.

5 Clinical Pharmacy and Translational Science, University of Tennessee Health Science Center College of Pharmacy, Knoxville, Tennessee.

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November 2018
6 Reads

Precision Medicine in Neurocritical Care.

JAMA Neurol 2018 Dec;75(12):1463-1464

Brain and Spinal Injury Center, Department of Neurology, Zuckerberg San Francisco General Hospital, University of California, San Francisco.

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December 2018
7 Reads

Preventing Chronic Emotional Distress in Stroke Survivors and Their Informal Caregivers.

Neurocrit Care 2018 Nov 12. Epub 2018 Nov 12.

Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Harvard Medical School/Massachusetts General Hospital, One Bowdoin Square, 1st Floor, Boston, MA, 02114, USA.

Background/objective: Chronic emotional distress (e.g., depression, anxiety, post-traumatic stress) is common after stroke and interdependent between patients and their informal caregivers. Read More

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November 2018
9 Reads

Recurrent focal seizures as a feature of status epilepticus presenting as a peri-ictal water drinking.

Epilepsy Behav Case Rep 2018 9;10:129-132. Epub 2018 Oct 9.

University Hospitals - Cleveland Medical Center, Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, OH, USA.

We report a case of focal status epilepticus (SE) associated with peri-ictal water drinking (PIWD) behavior in a nine-year-old left-handed boy with epilepsy. We reviewed prior cases of epileptic peri-ictal water drinking. Only one adult patient with status epilepticus and PIWD has been reported previously. Read More

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October 2018
1 Read

The effects of normovolemic anemia and blood transfusion on cerebral microcirculation after severe head injury.

Intensive Care Med Exp 2018 Nov 8;6(1):46. Epub 2018 Nov 8.

Critical Care Research Group, University of Queensland, Brisbane, Queensland, Australia.

Background: Cerebral regional microcirculation is altered following severe head injury. In addition to tissue disruption, partial pressure of tissue oxygenation is impaired due to an increase in the oxygen tissue gradient. The heterogenic distribution of cerebral microcirculation is multifactorial, and acute anemia challenges further the delivery of oxygen to tissues. Read More

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November 2018
1 Read

[Modern principles of neurocritical care].

Authors:
Julian Bösel

Nervenarzt 2018 Dec;89(12):1411-1427

Klinik für Neurologie, Klinikum Kassel, Mönchebergstr. 41-43, 34125, Kassel, Deutschland.

Neurological diseases frequently demanding admittance to a dedicated neurological intensive care unit (neurocritical care) comprise space-occupying ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage, traumatic brain injury, status epilepticus, bacterial meningitis, myasthenic crisis and Guillain-Barré syndrome. Due to often necessary analgesia, sedation and mechanical ventilation, neuromonitoring should ideally be employed. This consists of bedside invasive and non-invasive methods for monitoring cerebral perfusion, oxygenation, metabolism and neurophysiology. Read More

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December 2018
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