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The Role of Osmotic Therapy in Hemispheric Stroke
Conclusion Our results suggest that patients with moderate size hemispheric infarcts on presentation and those who do not require OT within the first 24 h of stroke may survive until discharge with medical management alone. Black race was also associated with conservative management failure, a finding that may reflect a cultural preference toward aggressive management. Further prospective studies are needed to better establish the utility of medical management of hemispheric edema in the setting of moderate size hemispheric infarcts.
Source: Neurocritical Care - July 1, 2015 Category: Neurology Source Type: research

Vancomycin Pharmacokinetic Parameters in Patients with Hemorrhagic Stroke
Conclusions Patients with hemorrhagic stroke exhibited pharmacokinetic alterations favoring increased elimination of vancomycin when compared to predicted pharmacokinetic parameters based on population data. This may result in underexposure to vancomycin, leading to treatment failure and other medical complications.
Source: Neurocritical Care - March 4, 2016 Category: Neurology Source Type: research

Attitudes of Nurses Toward Disability and Treatment in Space-Occupying Middle Cerebral Artery Stroke
ConclusionMost German nurses indicate moderately severe disability after SOS not to be acceptable, without emphasizing the presence of aphasia. The results call for greater scientific efforts in order to find reliable predictors for outcome after SOS.
Source: Neurocritical Care - August 2, 2018 Category: Neurology Source Type: research

Increased Neutrophil-to-Lymphocyte Ratio is Associated with Unfavorable Functional Outcome in Acute Ischemic Stroke
ConclusionsIn AIS patients we identified NLR as an important predictor for unfavorable functional outcome.
Source: Neurocritical Care - October 14, 2019 Category: Neurology Source Type: research

Burden of Epileptiform Activity Predicts Discharge Neurologic Outcomes in Severe Acute Ischemic Stroke
ConclusionsElectrographic seizures and periodic and rhythmic patterns in patients with AIS are associated with worse outcomes in a dose-dependent manner. Future studies are needed to assess whether treatment of this EEG activity can improve outcomes.
Source: Neurocritical Care - April 2, 2020 Category: Neurology Source Type: research

Prevalence, Predictors, and Outcomes of Prolonged Mechanical Ventilation After Endovascular Stroke Therapy
ConclusionsAmong a nationally representative sample of hospitalizations, nearly one-in-six patients had prolonged mechanical ventilation after EVT. Heart failure and diabetes were significantly associated with prolonged mechanical ventilation following EVT. Prolonged ventilation was associated with significant increase in in-hospital mortality and morbidity.
Source: Neurocritical Care - October 21, 2020 Category: Neurology Source Type: research

Hypoperfusion Intensity Ratio Predicts Malignant Edema and Functional Outcome in Large-Vessel Occlusive Stroke with Poor Revascularization
ConclusionsYounger age, larger core infarct volume, and higher HIR are predictive of MCE in patients with anterior circulation LVO, moderate-to-large tissue at risk, and suboptimal revascularization. HIR is correlated with three-month functional outcomes.
Source: Neurocritical Care - November 16, 2020 Category: Neurology Source Type: research

Glyburide Advantage in Malignant Edema and Stroke (GAMES-RP) Trial: Rationale and Design
Conclusions GAMES-RP was designed to provide critical information regarding glyburide for injection in patients with large hemispheric stroke and will inform the design of future studies.
Source: Neurocritical Care - August 12, 2015 Category: Neurology Source Type: research

Emergency Neurological Life Support: Acute Ischemic Stroke
Abstract Acute ischemic stroke is a neurological emergency that can be treated with time-sensitive interventions, including intravenous thrombolysis and endovascular approaches. Extensive study has demonstrated that rapid assessment and treatment are essential for improving neurological outcome. For this reason, acute ischemic stroke was chosen as an Emergency Neurological Life Support protocol. The protocol focuses on the first hour following the onset of neurological deficit.
Source: Neurocritical Care - October 5, 2015 Category: Neurology Source Type: research

Patient Age and the Outcomes after Decompressive Hemicraniectomy for Stroke: A Nationwide Inpatient Sample Analysis
Conclusion In this nationwide analysis, DHC was associated with reduced mortality regardless of patient age, including among those aged greater than 70 years. However, patients aged greater than 60 years treated surgically experienced higher odds of mortality (32.4 %), discharge to institutional care (47.1 %), and a poor outcome (77.0 %) compared with younger patients.
Source: Neurocritical Care - July 11, 2016 Category: Neurology Source Type: research

Emergency Neurological Life Support: Acute Ischemic Stroke
AbstractAcute ischemic stroke is a neurological emergency that can be treated with time-sensitive interventions, including both intravenous thrombolysis and endovascular approaches to thrombus removal. Extensive study has demonstrated that rapid, protocolized, assessment and treatment is essential to improving neurological outcome. For this reason, acute ischemic stroke was chosen as an emergency neurological life support protocol. The protocol focuses on the first hour of medical care following the acute onset of a neurological deficit.
Source: Neurocritical Care - September 14, 2017 Category: Neurology Source Type: research

Predictors for Tracheostomy with External Validation of the Stroke-Related Early Tracheostomy Score (SETscore)
ConclusionsSETscore is a simple score with a moderate accuracy and with a fair AUC used to predict the need for TR after MV for IS, ICH, and SAH patients. Our study also demonstrates that early TR was associated with a lower ICU LOS and VD in our cohort. The utility of this score may be improved when including additional variables such as BMI, AA race, ICH, and positive sputum cultures.
Source: Neurocritical Care - August 30, 2018 Category: Neurology Source Type: research

Emergency Free-Hand Bedside Catheter Evacuation of Large Intracerebral Hematomas Following Thrombolysis for Ischemic Stroke: A Case Series
ConclusionsEmergency free-hand bedside catheter aspiration is a reasonable option for hematoma evacuation in large thrombolysis-associated sICH when performed by experienced neurosurgeons. Larger studies would help in determining the generalizability of our findings to other centers and assessing their impact on functional outcome.
Source: Neurocritical Care - December 2, 2019 Category: Neurology Source Type: research

Quantitative Serial CT Imaging-Derived Features Improve Prediction of Malignant Cerebral Edema after Ischemic Stroke
ConclusionIncorporating quantitative CT-based imaging features from baseline and 24-h CT enhances identification of patients with malignant edema needing DHC. Further refinements and external validation of such imaging-based machine-learning models are required.
Source: Neurocritical Care - July 28, 2020 Category: Neurology Source Type: research

Early Prediction of Malignant Edema After Successful Recanalization in Patients with Acute Ischemic Stroke
ConclusionsThe extent of postinterventional cerebral hyperdensities on postinterventional non-contrast-enhanced CT was associated with malignant brain edema. The Hyperdensity on CT Score could be used to predict malignant brain edema regardless of the component of postinterventional cerebral hyperdensities.
Source: Neurocritical Care - November 8, 2021 Category: Neurology Source Type: research

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