Feasibility of Magnetic Resonance-Based Conductivity Imaging as a Tool to Estimate the Severity of Hypoxic-Ischemic Brain Injury in the First Hours After Cardiac Arrest
ConclusionsThe conductivity of cerebral tissue was increased in the first hours after ROSC, and the increase was more prominent and lasted longer in the 12-min group than in the 5-min group. Our findings suggest the promising potential of MRCI as a tool to estimate the severity of HIBI in the early hours after cardiac arrest. (Source: Neurocritical Care)
Source: Neurocritical Care - June 23, 2023 Category: Neurology Source Type: research
Association Between Neutrophil –Lymphocyte Ratio and 30-Day Infection and Thrombotic Outcomes After Intraventricular Hemorrhage: A CLEAR III Analysis
ConclusionsSerum NLR ascertained at baseline and on day 3 after randomization was associated with 30-day infection, whereas NLR obtained on day 5 was associated with thrombotic events after ICH, suggesting that NLR could be a potential early biomarker for ICH-related complications. (Source: Neurocritical Care)
Source: Neurocritical Care - June 22, 2023 Category: Neurology Source Type: research
Early Shared Decision-Making for Older Adults with Traumatic Brain Injury: Using Time-Limited Trials and Understanding Their Limitations
AbstractOlder adults account for a disproportionate share of the morbidity and mortality after traumatic brain injury (TBI). Predicting functional and cognitive outcomes for individual older adults after TBI is challenging in the acute phase of injury. Given that neurologic recovery is possible and uncertain, life-sustaining therapy may be pursued initially, even if for some, there is a risk of survival to an undesired level of disability or dependence. Experts recommend early conversations about goals of care after TBI, but evidence-based guidelines for these discussions or for the optimal method for communicating prognos...
Source: Neurocritical Care - June 22, 2023 Category: Neurology Source Type: research
Cognitive Motor Dissociation: Gap Analysis and Future Directions
ConclusionsTo improve the management of patients with disorders of consciousness, research efforts should address these mechanistic, epidemiological, bioengineering, and educational gaps to enable large-scale implementation of CMD assessment in clinical practice. (Source: Neurocritical Care)
Source: Neurocritical Care - June 22, 2023 Category: Neurology Source Type: research
Resolution of Cerebral Inflammation Following Subarachnoid Hemorrhage
ConclusionsBy the herein presented molecular and histological data we provide an important indication for an incomplete resolution of inflammation within the brain parenchyma after SAH. Inflammatory resolution and the return to tissue homeostasis represent an important contribution to the disease ’s pathology influencing the impact on brain damage and outcome after SAH. Therefore, we consider a novel complementary or even superior therapeutic approach that should be carefully rethought in the management of cerebral inflammation after SAH. An acceleration of the resolution phase at the cell ular and molecular levels could...
Source: Neurocritical Care - June 22, 2023 Category: Neurology Source Type: research
Emergency Medical Management of Aneurysmal Subarachnoid Hemorrhage
AbstractAneurysmal subarachnoid hemorrhage is a medical emergency that necessitates direct transfer to a tertiary referral center specialized in the diagnosis and treatment of this condition. The initial hours after aneurysmal rupture are critical for patients with aneurysmal subarachnoid hemorrhage, both in terms of rebleeding and combating the effect of early brain injury. No good treatment options are available to reduce the risk of rebleeding before aneurysm occlusion. Lowering the blood pressure may reduce the risk of rebleeding but carries a risk of inducing delayed cerebral ischemia or aggravating the consequences o...
Source: Neurocritical Care - June 21, 2023 Category: Neurology Source Type: research
NimoTop or NimoStop?
(Source: Neurocritical Care)
Source: Neurocritical Care - June 21, 2023 Category: Neurology Source Type: research
Who Determines the Quality of Life of Survivors of Severe Traumatic Brain Injury?
(Source: Neurocritical Care)
Source: Neurocritical Care - June 20, 2023 Category: Neurology Source Type: research
Individualized Thresholds of Hypoxemia and Hyperoxemia and their Effect on Outcome in Acute Brain Injured Patients: A Secondary Analysis of the ENIO Study
ConclusionsIn patients with ABI, hypoxemia and mild/moderate hyperoxemia were relatively frequent. Hypoxemia and hyperoxemia during ICU stay may influence in-hospital mortality. However, the small number of oxygen values collected represents a major limitation of the study. (Source: Neurocritical Care)
Source: Neurocritical Care - June 15, 2023 Category: Neurology Source Type: research
Multicenter Comparison of the Safety and Efficacy of Clopidogrel Versus Ticagrelor for Neuroendovascular Stents
ConclusionsUsing DAPT-C or DAPT-T regimens in a broad population of neuroendovascular stenting procedures appears to have similar safety and efficacy profiles. Further prospective evaluation is warranted to streamline the practice of DAPT selection and monitoring to determine the impact on clinical outcomes. (Source: Neurocritical Care)
Source: Neurocritical Care - June 15, 2023 Category: Neurology Source Type: research
The Change in Fibrinogen is Associated with Outcome in Patients with Acute Ischemic Stroke Treated with Endovascular Thrombectomy
ConclusionsIn patients with endovascular thrombectomy, hyperfibrinogenemia on admission was associated with poor functional outcomes at 3 months, whereas Δfibrinogen was associated with poor 3-month outcomes in a possible U-shaped manner. (Source: Neurocritical Care)
Source: Neurocritical Care - June 14, 2023 Category: Neurology Source Type: research
Early Intravenous Beta-Blockade with Esmolol in Adults with Severe Traumatic Brain Injury (EBB-TBI): Protocol for a Phase 2a Intervention Design Study
AbstractTraumatic brain injury is a leading cause of death and disability worldwide. Interventions that mitigate secondary brain injury have the potential to improve outcomes for patients and reduce the impact on communities and society. Increased circulating catecholamines are associated with worse outcomes and there are supportive animal data and indications in human studies of benefit from beta-blockade after severe traumatic brain injury. Here, we present the protocol for a dose-finding study using esmolol in adults commenced within 24 h of severe traumatic brain injury. Esmolol has practical advantages and theoretic...
Source: Neurocritical Care - June 12, 2023 Category: Neurology Source Type: research
Rapid Versus Gradual Weaning of External Ventricular Drain: A Systematic Literature Review and Meta-analysis
AbstractThe insertion of an external ventricular drain (EVD) is one of the most common neurosurgical procedures. Whether the weaning method (gradual or rapid) influences the ventriculoperitoneal shunt (VPS) insertion rate has not been conclusively established. The aim of this study is to provide a systematic literature review and conduct a meta-analysis of studies comparing gradual with rapid EVD weaning regarding VPS insertion rate. Articles were identified by searching the Pubmed/Medline, Embase, and Web of Science databases throughout October 2022. Two independent researchers assessed the studies for inclusion and quali...
Source: Neurocritical Care - June 12, 2023 Category: Neurology Source Type: research
Pretreatment with Clodronate Improved Neurological Function by Preventing Reduction of Posthemorrhagic Cerebral Blood Flow in Experimental Subarachnoid Hemorrhage
ConclusionsOur study proposes that pretreatment with CLD-targeting PVMs can improve the prognosis of severe SAH through a candidate mechanism of inhibition of posthemorrhagic CBF reduction. (Source: Neurocritical Care)
Source: Neurocritical Care - June 12, 2023 Category: Neurology Source Type: research
The Loss of Temporal Muscle Volume is Associated with Poor Outcome in Patients with Subarachnoid Hemorrhage: An Observational Cohort Study
ConclusionsTemporal muscle volume, which is easily assessable on routine head CT scans, progressively decreases during the ICU stay after spontaneous subarachnoid hemorrhage. Because of its association with disease severity and functional outcome, it may serve as a biomarker for muscle wasting and outcome prognostication. (Source: Neurocritical Care)
Source: Neurocritical Care - June 12, 2023 Category: Neurology Source Type: research
