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Source: Neurocritical Care

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Total 235 results found since Jan 2013.

Early Hyperchloremia is Independently Associated with Death or Disability in Patients with Intracerebral Hemorrhage
ConclusionsThe independent association between hyperchloremia and death or disability at 90  days suggests that avoidance of hyperchloremia may reduce the observed death or disability in patients with ICH.Clinical Trial RegistrationClinicalTrials.gov: NCT01176565.
Source: Neurocritical Care - May 5, 2022 Category: Neurology Source Type: research

A Pilot Study of the Fluctuating Mental Status Evaluation: A Novel Delirium Screening Tool for Neurocritical Care Patients
ConclusionsIn this pilot study, the FMSE achieved a high sensitivity and specificity in detecting delirium. Follow-up validation studies in a larger more diverse cohort of neurocritical care patients will use score cutoffs of  ≥ 1 as “possible” delirium and ≥ 2 as “probable” delirium.
Source: Neurocritical Care - October 14, 2022 Category: Neurology Source Type: research

Early Low Pulse Pressure in VA-ECMO Is Associated with Acute Brain Injury
ConclusionsEarly low pulse pressure (<  20 mm Hg) was associated with ABI in VA-ECMO patients. Low pulse pressure may serve as a marker of ABI risk, which necessitates close neuromonitoring for early detection.
Source: Neurocritical Care - June 1, 2023 Category: Neurology Source Type: research

TCCD Fusion Imaging to Estimate Intracranial Pressure and Tissue Displacement with Large Hemispheric Infarction
ConclusionsFusion imaging is an easy method to access and acquire measurements for critical care patients and follow-up of tissue and vascular displacement after stroke. Fusion imaging may be a decisive support for indicating hemicraniectomy.
Source: Neurocritical Care - July 6, 2023 Category: Neurology Source Type: research

Common Data Elements for Disorders of Consciousness: Recommendations from the Working Group on Behavioral Phenotyping
ConclusionsThe proposed behavioral phenotyping CDEs will assist with international harmonization of DoC studies and allow for more precise characterization of study cohorts, favorably impacting observational studies and clinical trials aimed at improving outcome in this population.
Source: Neurocritical Care - September 19, 2023 Category: Neurology Source Type: research

Intracranial Pressure and Cerebral Perfusion Pressure Monitoring in Non-TBI Patients: Special Considerations
Abstract The effect of intracranial pressure (ICP) and the role of ICP monitoring are best studied in traumatic brain injury (TBI). However, a variety of acute neurologic illnesses e.g., subarachnoid hemorrhage, intracerebral hemorrhage, ischemic stroke, meningitis/encephalitis, and select metabolic disorders, e.g., liver failure and malignant, brain tumors can affect ICP. The purpose of this paper is to review the literature about ICP monitoring in conditions other than TBI and to provide recommendations how the technique may be used in patient management. A PubMed search between 1980 and September 2013 identifie...
Source: Neurocritical Care - September 11, 2014 Category: Neurology Source Type: research

Monitoring Biomarkers of Cellular Injury and Death in Acute Brain Injury
Conclusion Current studies vary significantly in patient selection, biosample collection/processing, and biomarker measurement protocols, thereby limiting the generalizability of overall results. Future large prospective studies with standardized treatment, biosample collection, and biomarker measurement and validation protocols are necessary to identify high-fidelity biomarkers in neurocritical care.
Source: Neurocritical Care - September 11, 2014 Category: Neurology Source Type: research

Evidence-Based Guidelines for the Management of Large Hemispheric Infarction
Abstract Large hemispheric infarction (LHI), also known as malignant middle cerebral infarction, is a devastating disease associated with significant disability and mortality. Clinicians and family members are often faced with a paucity of high quality clinical data as they attempt to determine the most appropriate course of treatment for patients with LHI, and current stroke guidelines do not provide a detailed approach regarding the day-to-day management of these complicated patients. To address this need, the Neurocritical Care Society organized an international multidisciplinary consensus conference on the cri...
Source: Neurocritical Care - January 21, 2015 Category: Neurology Source Type: research

Factors Related to Delays in Pre-hospital Management of Status Epilepticus
Conclusion We found remarkable inadequacy in recognition of SE both among laity and medical professionals. There is an obvious need for increasing awareness of imminent SE and optimizing the pre-hospital management of established SE. SE should be considered as a medical emergency comparable with stroke and cardiac infarction and be allocated with similar resources in the pre-hospital management.
Source: Neurocritical Care - January 29, 2015 Category: Neurology Source Type: research

Complications Associated with Decompressive Craniectomy: A Systematic Review
Abstract Decompressive craniectomy (DC) has been used for many years in the management of patients with elevated intracranial pressure and cerebral edema. Ongoing clinical trials are investigating the clinical and cost effectiveness of DC in trauma and stroke. While DC has demonstrable efficacy in saving life, it is accompanied by a myriad of non-trivial complications that have been inadequately highlighted in prospective clinical trials. Missing from our current understanding is a comprehensive analysis of all potential complications associated with DC. Here, we review the available literature, we tabulate all re...
Source: Neurocritical Care - June 2, 2015 Category: Neurology Source Type: research

Prognostic and Mechanistic Factors Characterizing Seizure-Associated Crossed Cerebellar Diaschisis
Conclusions Collectively, these observations indicate that imaging findings of persistent cerebral restricted diffusion and cytotoxic edema in the subacute post-ictal period may predict irreversible neuronal injury and poor long-term outcome—even when accompanied by evidence of cortical hyperperfusion and recovery of second- and third-order neurons along the involved circuit.
Source: Neurocritical Care - June 11, 2015 Category: Neurology Source Type: research

Adverse Outcomes After Initial Non-surgical Management of Subdural Hematoma: A Population-Based Study
Conclusions Approximately one in eight patients with a conservatively managed SDH was readmitted with SDH within 90 days. A substantial proportion of these readmissions involved surgical hematoma evacuation. These outcomes occurred significantly more often after nontraumatic as compared to traumatic SDH.
Source: Neurocritical Care - July 10, 2015 Category: Neurology Source Type: research

Mandatory Intensivist Management Decreases Length of Stay, Facilitates an Increase in Admissions and Minimizes Closure of a Neurocritical Care Unit
Conclusions Implementation of mandatory intensivist management in the NCC unit decreased LOS, increased admissions, and decreased service line closure rates, while maintaining patient care.
Source: Neurocritical Care - July 25, 2015 Category: Neurology Source Type: research

Emergency Neurological Life Support: Intracerebral Hemorrhage
Abstract Intracerebral hemorrhage (ICH) is a subset of stroke due to bleeding within the parenchyma of the brain. It is potentially lethal, and survival depends on ensuring an adequate airway, reversal of coagulopathy, and proper diagnosis. ICH was chosen as an Emergency Neurological Life Support protocol because intervention within the first critical hour may improve outcome, and it is critical to have site-specific protocols to drive care quickly and efficiently.
Source: Neurocritical Care - October 5, 2015 Category: Neurology Source Type: research

Non-invasive Monitoring of Dynamic Cerebrovascular Autoregulation Using Near Infrared Spectroscopy and the Finometer Photoplethysmograph
Conclusions The results suggest that dynamic cerebrovascular autoregulation can be continuously assessed entirely non-invasively using nTOx. This allows for autoregulation assessment using spontaneous blood pressure fluctuations in conditions where iABP is not routinely monitored. The nABPOPT might deviate from iABPOPT, likely because of discordance between absolute nABP and iABP readings.
Source: Neurocritical Care - October 21, 2015 Category: Neurology Source Type: research