Therapies for Delayed Cerebral Ischemia in Aneurysmal Subarachnoid Hemorrhage
AbstractDelayed cerebral ischemia (DCI) is one of the most important complications of subarachnoid hemorrhage. Despite lack of prospective evidence, medical rescue interventions for DCI include hemodynamic augmentation using vasopressors or inotropes, with limited guidance on specific blood pressure and hemodynamic parameters. For DCI refractory to medical interventions, endovascular rescue therapies (ERTs), including intraarterial (IA) vasodilators and percutaneous transluminal balloon angioplasty, are the cornerstone of management. Although there are no randomized controlled trials assessing the efficacy of ERTs for DCI ...
Source: Neurocritical Care - May 25, 2023 Category: Neurology Source Type: research
Neurological Pupil Index and Delayed Cerebral Ischemia after Subarachnoid Hemorrhage: A Retrospective Multicentric Study
ConclusionsIn this study, NPi measured three times a day and derived from the automated pupillometry had a limited value for the diagnosis of DCI in patients with SAH. (Source: Neurocritical Care)
Source: Neurocritical Care - May 24, 2023 Category: Neurology Source Type: research
Quantitative Pupillometry: Not a Clear Predictor of Delayed Cerebral Ischemia After Subarachnoid Hemorrhage
(Source: Neurocritical Care)
Source: Neurocritical Care - May 24, 2023 Category: Neurology Source Type: research
Aquaporin 4 Mediates the Effect of Iron Overload on Hydrocephalus After Intraventricular Hemorrhage
ConclusionsAQP4 located in the periventricular area mediated the effect of iron overload on hydrocephalus after IVH. (Source: Neurocritical Care)
Source: Neurocritical Care - May 19, 2023 Category: Neurology Source Type: research
Guidelines for the Neurocritical Care Management of Aneurysmal Subarachnoid Hemorrhage
ConclusionsThese guidelines provide recommendations for or against interventions proven to be effective, ineffective, or harmful in the medical management of patients with aSAH based on a rigorous review of the available literature. They also serve to highlight gaps in knowledge that should guide future research priorities. Despite improvements in the outcomes of patients with aSAH over time, many important clinical questions remain unanswered. (Source: Neurocritical Care)
Source: Neurocritical Care - May 18, 2023 Category: Neurology Source Type: research
Subarachnoid Hemorrhage Management Guidelines: Perspectives on Methodology and Clinical Guidance
(Source: Neurocritical Care)
Source: Neurocritical Care - May 18, 2023 Category: Neurology Source Type: research
CSF-Based Volumetric Imaging Biomarkers Highlight Incidence and Risk Factors for Cerebral Edema After Ischemic Stroke
ConclusionsCerebral edema can be measured in a majority of patients with stroke on follow-up computed tomography using volumetric biomarkers evaluating CSF shifts, including in many without visible midline shift. Edema formation is influenced by clinical and radiographic stroke severity but also by chronic vascular risk factors and contributes to worse stroke outcomes. (Source: Neurocritical Care)
Source: Neurocritical Care - May 15, 2023 Category: Neurology Source Type: research
Perioperative Neuromonitoring in Children with Congenital Heart Disease
AbstractAlthough neonates and children with congenital heart disease are primarily hospitalized for cardiac and pulmonary diseases, they are also at an increased risk for neurologic injury due to both empiric differences that can exist in their nervous systems and acquired injury from cardiopulmonary pathology and interventions. Although early efforts in care focused on survival after reparative cardiac surgery, as surgical and anesthetic techniques have evolved and survival rates accordingly improved, the focus has now shifted to maximizing outcomes among survivors. Children and neonates with congenital heart disease expe...
Source: Neurocritical Care - May 15, 2023 Category: Neurology Source Type: research
Palliative Care in Severe Neurotrauma Patients in the Intensive Care Unit
This article highlights the different aspects of the palliative care approach as well as barriers and challenges that accompany the TBI patient population, with a pa rticular focus on young adult patients with TBI and the role of their family members. The article concludes with recommendations for physicians for effective and adequate communication to successfully implement the palliative care approach into standard ICU care and to improve quality of care for pa tients with TBI and their families. (Source: Neurocritical Care)
Source: Neurocritical Care - May 12, 2023 Category: Neurology Source Type: research
Integrating Palliative Care into the Neurointensive Care Unit
(Source: Neurocritical Care)
Source: Neurocritical Care - May 12, 2023 Category: Neurology Source Type: research
Are We Ready for Clinical Therapy based on Cerebral Autoregulation? A Pro-con Debate
This article examines the technological advances in monitoring techniques and the accuracy of continuous assessment of autoregulation techniques used in intraoperative and intensive care settings today. It also examines how increasing knowledge of CA from recent clinical trials contributes to a greater understanding of secondary brain injury in many disease processes, despite the fact that the lack of robust evidence influencing outcomes has prevented the translation of CA-guided algorithms into clinical practice. (Source: Neurocritical Care)
Source: Neurocritical Care - May 10, 2023 Category: Neurology Source Type: research
Ketamine Use in the Intubation of Critically Ill Children with Neurological Indications: A Multicenter Retrospective Analysis
ConclusionsThis retrospective cohort study did not demonstrate an association between procedural ketamine use and increased risk of peri-intubation hypoxemia and hemodynamic instability in patients intubated for neurological indications. (Source: Neurocritical Care)
Source: Neurocritical Care - May 9, 2023 Category: Neurology Source Type: research
Hemodynamic Management in the Prevention and Treatment of Delayed Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage
AbstractOne of the most serious complications after subarachnoid hemorrhage (SAH) is delayed cerebral ischemia, the cause of which is multifactorial. Delayed cerebral ischemia considerably worsens neurological outcome and increases the risk of death. The targets of hemodynamic management of SAH have widely changed over the past 30 years. Hypovolemia and hypotension were favored prior to the era of early aneurysmal surgery but were subsequently replaced by the use of hypervolemia and hypertension. More recently, the concept of goal-directed therapy targeting euvolemia, with or without hypertension, is gaining preference. ...
Source: Neurocritical Care - May 9, 2023 Category: Neurology Source Type: research
Noninvasive Neuromonitoring Modalities in Children Part I: Pupillometry, Near-Infrared Spectroscopy, and Transcranial Doppler Ultrasonography
ConclusionsFuture prospective multicenter work addressing major knowledge gaps is necessary to advance the field of pediatric noninvasive neuromonitoring. (Source: Neurocritical Care)
Source: Neurocritical Care - May 9, 2023 Category: Neurology Source Type: research
Correction: Advanced Neuromonitoring Modalities on the Horizon: Detection and Management of Acute Brain Injury in Children
(Source: Neurocritical Care)
Source: Neurocritical Care - May 9, 2023 Category: Neurology Source Type: research
