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Source: Neurocritical Care
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Total 235 results found since Jan 2013.
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 - May 15, 2023 Category: Neurology Source Type: research
Barriers to Surrogate Application of Patient Values in Medical Decisions in Acute Stroke: Qualitative Study in a Biethnic Community
ConclusionsStroke surrogate decision-makers may benefit from (1) continued efforts to make advance care planning more common and more relevant, (2) assistance in how to apply their knowledge of patient values to actual treatment decisions, and (3) psychosocial support to reduce emotional burden. Barriers to surrogate application of patient values were generally similar in MA and NHW participants, though the possibility of greater guilt or burden among MA surrogates warrants further investigation and confirmation.
Source: Neurocritical Care - May 2, 2023 Category: Neurology Source Type: research
Heart Rate Variability in Patients with Spontaneous Intracerebral Hemorrhage and its Relationship with Clinical Outcomes
ConclusionsHRV values were impaired significantly within 14 days after ICH. Furthermore, HRV indices measured 10–14 days after ICH were independently associated with 3-month outcomes.
Source: Neurocritical Care - March 29, 2023 Category: Neurology Source Type: research
Neuromonitoring in Children with Cerebrovascular Disorders
ConclusionsOur understanding of pediatric cerebrovascular disorders has increased dramatically over the past several years, in part due to advances in the neuromonitoring modalities that allow us to better understand these conditions. We are now poised, as a field, to take advantage of advances in neuromonitoring capabilities to determine how best to manage and treat acute cerebrovascular disorders in children.
Source: Neurocritical Care - February 24, 2023 Category: Neurology Source Type: research
Adherence to Established Blood Pressure Targets and Associated Complications in Patients Presenting with Acute Intracerebral Hemorrhage
ConclusionsIn individuals with nontraumatic/nonaneurysmal ICH, SBP measurements were observed to be < 140 mm Hg for > 50% of the initial 48 h following admission. Hypotension and relative SBP reduction > 20% were also independent predictors of renal adverse events. SBP reduction > 20% was also an independent predictor of brain ischemia. These data indicate that intensive SBP reduction following ICH predispose patients to secondary organ injury that may impact long-term outcomes. Our data suggest that a more modest lowering of the SBP within 48 h, as recommended in the mos t recent guidel...
Source: Neurocritical Care - February 14, 2023 Category: Neurology Source Type: research
One-Year Survival of Ischemic Stroke Patients Requiring Mechanical Ventilation
ConclusionsThe indication for intubation seems to significantly affect outcome. Functional outcome at 3 months is often poor, but a great majority of 1-year survivors are able to live at home.
Source: Neurocritical Care - February 9, 2023 Category: Neurology Source Type: research
Neuromonitoring During ECMO Support in Children
AbstractExtracorporeal membrane oxygenation is a potentially lifesaving intervention for children with severe cardiac or respiratory failure. It is used with increasing frequency and in increasingly more complex and severe diseases. Neurological injuries are important causes of morbidity and mortality in children treated with extracorporeal membrane oxygenation and include ischemic stroke, intracranial hemorrhage, hypoxic-ischemic injury, and seizures. In this review, we discuss the epidemiology and pathophysiology of neurological injury in patients supported with extracorporeal membrane oxygenation, and we review the curr...
Source: Neurocritical Care - January 31, 2023 Category: Neurology Source Type: research
Risk Factors for Anticoagulant-Associated Intracranial Hemorrhage: A Systematic Review and Meta-analysis
Conclusions This study informs risk prediction for anticoagulant-associated intracranial hemorrhage and informs guidelines for intracranial hemorrhage prevention and future research.
Source: Neurocritical Care - January 20, 2023 Category: Neurology Source Type: research
Association Between Hyperacute Blood Pressure Variability and Hematoma Expansion After Intracerebral Hemorrhage: Secondary Analysis of the FAST-MAG Database
ConclusionsHigher BPV was not found to be associated with occurrence of HE in the hyperacute or the acute period of spontaneous ICH. Further study is needed to determine the relationship.
Source: Neurocritical Care - December 5, 2022 Category: Neurology Source Type: research
Efficacy of Early Intensive Blood Pressure Management After Thrombectomy: Protocol for a Randomized Controlled Clinical Trial (IDENTIFY)
AbstractBackgroundThe optimal strategy for blood pressure management after thrombectomy remains unknown. The primary objective of The Early Intensive Blood Pressure Management after Endovascular Thrombectomy (IDENTIFY) study is to explore the efficacy and safety of early intensive blood pressure management strategies after thrombectomy compared with that of standard management.MethodsThe IDENTIFY study is a prospective, randomized, open-label, assessor-blinded multicenter clinical trial. Patients with acute anterior circulation ischaemic stroke who underwent endovascular thrombectomy within 6 h of stroke onset, ach...
Source: Neurocritical Care - November 3, 2022 Category: Neurology Source Type: research
Teleneurocritical Care for Patients with Large Vessel Occlusive Ischemic Stroke Treated by Thrombectomy
ConclusionsTeleneurocritical care allows for equivalent favorable functional outcomes compared with in-person neurocritical care for patients with acute large vessel ischemic stroke receiving thrombectomy. The standardized protocols used by TNCC in this study, specifically the comprehensive 24/7 treatment of patients in the intensive care unit for the length of their stay, may be relevant for other health systems with limited in-person resources; however, additional study is required.
Source: Neurocritical Care - November 2, 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
Emergency Bedside Catheter Evacuation of Deep Ganglionic Hematoma Following Recanalization Therapy in Ischemic Stroke
Source: Neurocritical Care - September 7, 2022 Category: Neurology Source Type: research
Weaning Outcomes in Patients with Brain Injury
ConclusionsPatients with acute brain injury, compared with patients without brain injury, present higher odds of undergoing unplanned extubated after weaning was started, lower odds of being extubated after the first attempt, and a higher risk of reintubation.
Source: Neurocritical Care - September 1, 2022 Category: Neurology Source Type: research
Andexanet-Alfa-Associated Heparin Resistance in the Context of Hemorrhagic Stroke
ConclusionsAlthough well known to hematologists, the phenomenon is underrecognized among stroke clinicians. However, patients with intracranial hemorrhage frequently undergo endovascular or surgical interventions that require periprocedural administration of heparin.
Source: Neurocritical Care - August 5, 2022 Category: Neurology Source Type: research
