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The Role of FEIBA in Reversing Novel Oral Anticoagulants in Intracerebral Hemorrhage
Conclusion In this small case series, reversal of NOAC with FEIBA was not associated with ICH expansion or any thrombotic or hemorrhagic complications.
Source: Neurocritical Care - November 6, 2015 Category: Neurology Source Type: research

Guideline for Reversal of Antithrombotics in Intracranial Hemorrhage
Conclusions This guideline provides timely, evidence-based reversal strategies to assist practitioners in the care of patients with antithrombotic-associated intracranial hemorrhage.
Source: Neurocritical Care - December 29, 2015 Category: Neurology Source Type: research

Systemic Inflammatory Response Syndrome and Outcomes in Intracerebral Hemorrhage
Conclusion We observed that approximately 20 % of patients with ICH develop SIRS, and that patients with SIRS were at increased risk of having poor functional outcome at discharge.
Source: Neurocritical Care - February 26, 2016 Category: Neurology Source Type: research

Severe Cerebral Venous and Sinus Thrombosis: Clinical Course, Imaging Correlates, and Prognosis
Conclusion The outcome of severe CVT is almost equally divided between severe impairment or death and survival with no or only mild handicap. Specifically, space-occupying mass effect and associated neurologic deterioration seem to determine a poor outcome. Therefore, early detection and treatment of mass effect should be the focus of critical care.
Source: Neurocritical Care - March 20, 2016 Category: Neurology Source Type: research

A Propensity Score-Matched Study of the Use of Non-steroidal Anti-inflammatory Agents Following Aneurysmal Subarachnoid Hemorrhage
Conclusions Inflammation may play a crucial role in the poor outcomes after SAH, and that NSAIDs may be a useful therapeutic option, once validated by larger prospective studies.
Source: Neurocritical Care - March 20, 2016 Category: Neurology Source Type: research

Headache and Its Approach in Today’s NeuroIntensive Care Unit
Abstract Headache is a very common symptom in the neurointensive care unit (neuroICU). While headache in the neuroICU can be caused by worsening of a pre-existing primary headache disorder, most are secondary to another condition. Additionally, headache can be the presenting symptom of a number of conditions requiring prompt recognition and treatment including subarachnoid hemorrhage, ischemic and hemorrhagic stroke, central nervous system infection, pituitary apoplexy, and cerebral vasoconstriction. The neuroICU also has a unique postoperative population in which postcraniectomy and postcraniotomy headache, posti...
Source: Neurocritical Care - March 20, 2016 Category: Neurology Source Type: research

Acute Posterior Cranial Fossa Hemorrhage—Is Surgical Decompression Better than Expectant Medical Management?
Conclusions SDC following PCFH was associated with a reduction in mortality compared to expectant MT with or without EVD insertion. A high-quality multicenter randomized control trial is required to evaluate the superiority of SDC for PCFH.
Source: Neurocritical Care - April 11, 2016 Category: Neurology Source Type: research

TURN Score Predicts 24-Hour Cerebral Edema After IV Thrombolysis
Conclusions Cerebral edema at 24 h is associated with poor outcome and 90-day mortality. TURN predicts ischemic stroke patients who will develop 24-h cerebral edema after IV thrombolysis.
Source: Neurocritical Care - May 28, 2016 Category: Neurology Source Type: research

Elevated Red Cell Distribution Width is Associated with Cerebral Infarction in Aneurysmal Subarachnoid Hemorrhage
ConclusionsRDW elevation is associated with cerebral infarction and poor outcome after aSAH. Further evaluation of this association is warranted as it may shed light on mechanistic relations between anemia, inflammation, and thrombosis after aSAH.
Source: Neurocritical Care - August 15, 2016 Category: Neurology Source Type: research

In-Hospital Mortality with Use of Percutaneous Endoscopic Gastrostomy in Traumatic Brain Injury Patients: Results of a Nationwide Population-Based Study
ConclusionUnderstanding the rate of mortality associated with PEG in this patient population and identifying factors that increase and decrease the risk of death will improve patient selection for those most likely to benefit from this procedure.
Source: Neurocritical Care - November 29, 2016 Category: Neurology Source Type: research

Acute Posterior Cranial Fossa Hemorrhage —Is Surgical Decompression Better than Expectant Medical Management?
ConclusionsSDC following PCFH was associated with a reduction in mortality compared to expectant MT with or without EVD insertion. A high-quality multicenter randomized control trial is required to evaluate the superiority of SDC for PCFH.
Source: Neurocritical Care - November 30, 2016 Category: Neurology Source Type: research

Early Mobilization in the Neuro-ICU: How Far Can We Go?
AbstractImmobility that is frequently encountered in the intensive care unit (ICU) can lead to patient complications. Early mobilization of patients in the ICU has been shown to reduce the complications associated with critical illness; however, early mobilization in the neurological intensive care unit (NICU) presents a unique challenge for the multidisciplinary team. The early mobilization of patients with acute neurologic injuries such as acute ischemic stroke, aneurysmal subarachnoid hemorrhage, intracerebral hemorrhage, and neurotrauma varies because of differing disease processes and management. When developing an ea...
Source: Neurocritical Care - December 19, 2016 Category: Neurology Source Type: research

Clinical Value of Neutrophil to Lymphocyte and Platelet to Lymphocyte Ratio After Aneurysmal Subarachnoid Hemorrhage
ConclusionsNLR and PLR as novel inflammatory biomarkers are independent predictors of DCI development and functional outcome after acute aSAH. When combined together, they may help to identify high-risk patients more powerfully.
Source: Neurocritical Care - December 26, 2016 Category: Neurology Source Type: research

Emergency Neurological Life Support: Intracerebral Hemorrhage
AbstractIntracerebral hemorrhage (ICH) is a subset of stroke due to spontaneous bleeding within the parenchyma of the brain. It is potentially lethal, and survival depends on ensuring an adequate airway, proper diagnosis, and early management of several specific issues such as blood pressure, coagulopathy reversal, and surgical hematoma evacuation for appropriate patients. ICH was chosen as an Emergency Neurological Life Support (ENLS) protocol because intervention within the first hours may improve outcome, and it is critical to have site-specific protocols to drive care quickly and efficiently.
Source: Neurocritical Care - September 14, 2017 Category: Neurology Source Type: research

Prophylactic Anticonvulsants in Intracerebral Hemorrhage
DiscussionLevetiracetam was routinely prescribed following ICH and was not associated with worse outcomes. Future investigations should examine the effect of prophylactic levetiracetam on cost and neuropsychological outcomes as well as the role of continuous EEG in identifying subclinical seizures.
Source: Neurocritical Care - October 1, 2017 Category: Neurology Source Type: research

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