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Source: Neurocritical Care
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Total 235 results found since Jan 2013.
The Routine Follow-up Head CT: Is it Still a Necessary Step in the Thrombolysis Pathway?
ConclusionsThe 24-h head CT scan does not change management for most patients, particularly those with low National Institutes of Health Stroke Scale scores who do not undergo MT. Consideration should be given to removing routine follow-up imaging from postthrombolysis protocols in favor of an examination-based approach.
Source: Neurocritical Care - September 27, 2021 Category: Neurology Source Type: research
Neuronal Swelling: A Non-osmotic Consequence of Spreading Depolarization
AbstractAn acute reduction in plasma osmolality causes rapid uptake of water by astrocytes but not by neurons, whereas both cell types swell as a consequence of lost blood flow (ischemia). Either hypoosmolality or ischemia can displace the brain downwards, potentially causing death. However, these disorders are fundamentally different at the cellular level. Astrocytes osmotically swell or shrink because they express functional water channels (aquaporins), whereas neurons lack functional aquaporins and thus maintain their volume. Yet both neuronsand astrocytes immediately swell when blood flow to the brain is compromised (c...
Source: Neurocritical Care - September 8, 2021 Category: Neurology Source Type: research
Midline Shift Greater than 3 mm Independently Predicts Outcome After Ischemic Stroke
ConclusionsThese results show that the presence of MLS predicts poor outcome and, specifically, MLS value greater than 3 mm is an important threshold across a variety of clinical settings. These findings may have relevance for the design and interpretation of future trials for antiedema therapies.
Source: Neurocritical Care - September 7, 2021 Category: Neurology Source Type: research
Taking a Chance to Recover: Families Look Back on the Decision to Pursue Tracheostomy After Severe Acute Brain Injury
ConclusionsAfter SABI, prognostic uncertainty almost transcends the concept of choice. Families who proceeded with a tracheostomy saw it as the only option at the time. High-quality communication may mitigate the stress surrounding this high-stakes decision.
Source: Neurocritical Care - September 2, 2021 Category: Neurology Source Type: research
Accelerating Prediction of Malignant Cerebral Edema After Ischemic Stroke with Automated Image Analysis and Explainable Neural Networks
ConclusionsAn LSTM neural network incorporating volumetric data extracted from routine CT scans identified all cases of malignant cerebral edema by 24 h after stroke, with significantly fewer false positives than a fully connected neural network, regression model, and the validated EDEMA score. This preliminary work requires prospective validation but provides proof of principle that a deep learning framework could assist in selecting patients f or surgery prior to deterioration.
Source: Neurocritical Care - August 20, 2021 Category: Neurology Source Type: research
The Effect of Data Length on the Assessment of Dynamic Cerebral Autoregulation with Transfer Function Analysis in Neurological ICU Patients
ConclusionsConsidering the acceptable rates for the data and the variation in the TFA variables (phase shift and gain), we recommend recording data for a minimum length of 7 min for TFA in patients in the neuro-ICU.
Source: Neurocritical Care - August 17, 2021 Category: Neurology Source Type: research
Influence of Patient-Specific Covariates on Test Validity of Two Delirium Screening Instruments in Neurocritical Care Patients (DEMON-ICU)
ConclusionsThe CAM-ICU and ICDSC perform well in patients requiring neurocritical care, regardless of the presence of acute stroke, TIA, or neurosurgical interventions. Yet, even very light or moderate sedation can significantly impair DSI performance.
Source: Neurocritical Care - August 9, 2021 Category: Neurology Source Type: research
Increased Incidence of In-Hospital Ischemic Stroke During SARS-CoV-2 Outbreak: A Single-Center Study
ConclusionsSARS-CoV-2 outbreak was associated with an increase in the incidence of IHIS when compared with inpatients from a historical cohort. Viral infection itself may be related to the increased risk of IHIS among patients with COVID-19, but in view of our results from the 20NCC, it is likely that other factors, such as hospital saturation and overwhelming of health systems, may have played a role in the increased frequency of IHIS.
Source: Neurocritical Care - July 15, 2021 Category: Neurology Source Type: research
Venous Injury in Patients with Blunt Traumatic Brain Injury: Retrospective Analysis of a National Cohort
ConclusionsWe identified a 0.3% incidence of CVI in all-comers with blunt TBI as well as several injury-related variables that may be used to guide investigation for dural venous sinus injury. CVI was associated with poorer outcomes, with superior sagittal sinus injury having the strongest association.
Source: Neurocritical Care - July 9, 2021 Category: Neurology Source Type: research
Role of Interleukin-1 Receptor-Like 1 (ST2) in Cerebrovascular Disease
AbstractFollowing both ischemic and hemorrhagic stroke, innate immune cells initiate a proinflammatory response that further exacerbate tissue injury in the acute phase, but these cells also play an important reparative role thereafter. Numerous cytokines and signaling pathways have been implicated in driving the deleterious proinflammatory response, but less is known about the mediators that connect the initial vascular injury to the systemic immune response and the relationship between proinflammatory and reparative immune responses. The Interleukin-33 (IL-33) and serum stimulation-2 (ST2) axis is an interleukin signalin...
Source: Neurocritical Care - July 6, 2021 Category: Neurology Source Type: research
Causes, Predictors, and Timing of Early Neurological Deterioration and Symptomatic Intracranial Hemorrhage After Administration of IV tPA
ConclusionsIn this study, only a small proportion suffered from either sICH and/or END, typically within 12 h of tPA administration. These findings may support earlier deescalation of higher acuity monitoring in clinically stable post-IV tPA patients without large vessel occlusion.
Source: Neurocritical Care - July 6, 2021 Category: Neurology Source Type: research
COVID-19 and the Pediatric Nervous System: Global Collaboration to Meet a Global Need
AbstractThe coronavirus disease 2019 (COVID-19) pandemic has affected mortality and morbidity across all ages, including children. It is now known that neurological manifestations of COVID-19, ranging from headaches to stroke, may involve the central and/or peripheral nervous system at any age. Neurologic involvement is also noted in the multisystem inflammatory syndrome in children, a pediatric condition that occurs weeks after infection with the causative virus of COVID-19, severe acute respiratory syndrome coronavirus 2. Knowledge about mechanisms of neurologic disease is scarce but rapidly growing. COVID-19 neurologic ...
Source: Neurocritical Care - June 28, 2021 Category: Neurology Source Type: research
Prognostic Utility of Daily Changes in Glasgow Coma Scale and the Full Outline of Unresponsiveness Score Measurement in Patients with Metabolic Encephalopathy, Central Nervous System Infections and Stroke in Uganda
ConclusionsTwenty-four-hour and 48-h ΔFOUR and ΔGCS are predictive of mortality in Ugandan patients with CNS infections and ME but not in those with stroke. For individuals with stroke, the admission score plays a more significant predictive role that the change in scores.
Source: Neurocritical Care - June 23, 2021 Category: Neurology Source Type: research
Hemodynamic Status During Endovascular Stroke Treatment: Association of Blood Pressure with Functional Outcome
ConclusionsIn our protocol-based setting, intraprocedural pre-recanalization BP reductions during endovascular therapy were not associated with functional outcome. However, higher intraprocedural pre-recanalization SBP and MAP were associated with worse functional outcome. Prospective randomized controlled studies are needed to determine whether BP is a feasible treatment target for the modification of outcomes.
Source: Neurocritical Care - June 17, 2021 Category: Neurology Source Type: research
Inflammasome Caspase-1 Activity is Elevated in Cerebrospinal Fluid After Aneurysmal Subarachnoid Hemorrhage and Predicts Functional Outcome
ConclusionsInflammasome-derived caspase-1 activity is elevated in the CSF of SAH patients compared to controls and higher levels correlate with worse functional outcome.
Source: Neurocritical Care - June 1, 2021 Category: Neurology Source Type: research
