Novel EEG Metric Correlates with Intracranial Pressure in an Animal Model
ConclusionsEEG ϕ angle is a promising real-time noninvasive measure of ICP/cerebral perfusion using surface electroencephalography. (Source: Neurocritical Care)
Source: Neurocritical Care - November 8, 2023 Category: Neurology Source Type: research
Intracranial Hypertension with Patent Basal Cisterns: Controlled Lumbar Drainage as a Therapeutic Option. Selected Case Series
ConclusionsOur study provides preliminary evidence that in selected patients who develop refractory intracranial hypertension with patent basal cisterns and no focal mass effect on computed tomography, controlled lumbar drainage appears to be a therapeutic option. In our study there were no deaths or complications. Prospective and larger studies are needed to confirm our results. (Source: Neurocritical Care)
Source: Neurocritical Care - November 7, 2023 Category: Neurology Source Type: research
Improved Transcranial Doppler Waveform Analysis for Intracranial Hypertension Assessment in Patients with Traumatic Brain Injury
ConclusionsIn the present study, discriminative power of the PaR for discriminating IH was superior to the PI. The PaR seems to be a reliable noninvasive parameter for detecting IH. Further studies are warranted to define its clinical application, especially in aiding neurosurgical decision making, following up in intensive care units, and defining its ability to indicate responses according to the therapies administered. (Source: Neurocritical Care)
Source: Neurocritical Care - November 6, 2023 Category: Neurology Source Type: research
Guidelines for Neuroprognostication in Critically Ill Adults with Intracerebral Hemorrhage
ConclusionsThese guidelines provide recommendations on the formal reliability of predictors of poor outcome in the context of counseling patients with ICH and surrogates and suggest broad principles of neuroprognostication. Clinicians formulating their judgments of prognosis for patients with ICH should avoid anchoring bias based solely on any one clinical variable or published clinical grading scale. (Source: Neurocritical Care)
Source: Neurocritical Care - November 3, 2023 Category: Neurology Source Type: research
The Origin of the Burst-Suppression Paradigm in Treatment of Status Epilepticus
AbstractAfter electroencephalography (EEG) was introduced in hospitals, early literature recognized burst-suppression pattern (BSP) as a distinctive EEG pattern characterized by intermittent high-power oscillations alternating with isoelectric periods in coma and epileptic encephalopathies of childhood or the pattern could be induced by general anesthesia and hypothermia. The term was introduced by Sw. and Watson in 1949 but was initially described by Derbyshire et al. in 1936 in their study about the anesthetic effects of tribromoethanol. Once the EEG/BSP pattern emerged in the literature as therapeutic goal in refractory...
Source: Neurocritical Care - November 3, 2023 Category: Neurology Source Type: research
Burst Suppression as a Treatment Goal in Refractory Status Epilepticus
(Source: Neurocritical Care)
Source: Neurocritical Care - November 3, 2023 Category: Neurology Source Type: research
Correction: Common Data Elements for Disorders of Consciousness: Recommendations from the Working Group on Behavioral Phenotyping
(Source: Neurocritical Care)
Source: Neurocritical Care - November 3, 2023 Category: Neurology Source Type: research
Clinical Trial Protocol for BEACH: A Phase 2a Study of MW189 in Patients with Acute Nontraumatic Intracerebral Hemorrhage
AbstractPatients with acute spontaneous intracerebral hemorrhage (ICH) develop secondary neuroinflammation and cerebral edema that can further damage the brain and lead to increased risk of neurologic complications. Preclinical studies in animal models of acute brain injury have shown that a novel small-molecule drug candidate, MW01-6-189WH (MW189), decreases neuroinflammation and cerebral edema and improves functional outcomes. MW189 was also safe and well tolerated in phase 1 studies in healthy adults. The proof-of-concept phase 2a Biomarker and Edema Attenuation in IntraCerebral Hemorrhage (BEACH) clinical trial is a ...
Source: Neurocritical Care - November 2, 2023 Category: Neurology Source Type: research
Ketamine for Status Epilepticus in Children: Searching for the Right Drug for the Right Patient
(Source: Neurocritical Care)
Source: Neurocritical Care - November 2, 2023 Category: Neurology Source Type: research
Overlapping Physiologic Signs of Sepsis and Paroxysmal Sympathetic Hyperactivity After Traumatic Brain Injury: Exploring A Clinical Conundrum
ConclusionsIn the presence of brain injury-induced autonomic nervous system dysregulation, the initiation and continuation of antimicrobial therapy is a challenging clinical decision, as standard physiologic markers of sepsis do not distinguish infected from noninfected patients with PSH, and these entities often present around the same time. Clinicians should be aware that PSH is a potential driver of SIRS, and familiarity with its diagnostic criteria as proposed by the PSH assessment measure is important. Management by a multidisciplinary team attentive to these issues may reduce rates of inappropriate antibiotic usage a...
Source: Neurocritical Care - October 26, 2023 Category: Neurology Source Type: research
Perspectives of Medical Organizations, Organ Procurement Organizations, and Advocacy Organizations About Revising the Uniform Determination of Death Act (UDDA)
ConclusionsMost commenting organizations support UDDA revision, but perspectives on the approach vary, so the Drafting Committee could not formulate revisions that would be agreeable to all stakeholders. (Source: Neurocritical Care)
Source: Neurocritical Care - October 26, 2023 Category: Neurology Source Type: research
The State of the Field of Pediatric Multimodality Neuromonitoring
ConclusionsThe possible benefits of multimodal neuromonitoring are immense and have great potential to advance the field of pediatric neurocritical care and the health of critically ill children. (Source: Neurocritical Care)
Source: Neurocritical Care - October 20, 2023 Category: Neurology Source Type: research
Standardized A-Scan Technique as Best Option in Optic Nerve Sheath Diameter Measurements and Troubles with Evaluation of Eyeball Transverse Diameter
(Source: Neurocritical Care)
Source: Neurocritical Care - October 19, 2023 Category: Neurology Source Type: research
In Reply: Standardized A-Scan Technique in Optic Nerve Sheath Diameter Measurements and Troubles With Evaluation of Eyeball Transverse Diameter
(Source: Neurocritical Care)
Source: Neurocritical Care - October 19, 2023 Category: Neurology Source Type: research
Inaugural State of the Union: Continuous Cerebral Autoregulation Monitoring in the Clinical Practice of Neurocritical Care and Anesthesia
AbstractHow continuous cerebral autoregulation (CCA) knowledge should be optimally gained and interpreted is still an active area of research and refinement. We now experience a unique situation of having indices clinically available before definitive evidence of benefit or practice guidelines, in a moment when high rates of institutional variability exist both in the application of monitoring as well as in monitoring-guided treatments. Responses from 47 international clinicians, experts in this field, were collected with polling and discussion of the results. The clinical use of CCA in critical illness was not universal a...
Source: Neurocritical Care - October 18, 2023 Category: Neurology Source Type: research
