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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

Stroke Risk Following Infection in Patients with Continuous-Flow Left Ventricular Assist Device
ConclusionsLVAD infections, particularly BSI, are significantly associated with stroke, and infection-related stroke conferred significantly lower cumulative survival.
Source: Neurocritical Care - January 14, 2019 Category: Neurology Source Type: research

Mechanical Ventilation for Acute Stroke: A Multi-state Population-Based Study
Conclusions In this large population-based sample, over half of mechanically ventilated stroke patients died in the hospital despite the fact that younger patients were more likely to receive mechanical ventilation. Future studies are indicated to elucidate mechanical ventilation strategies to optimize long-term outcomes after severe stroke.
Source: Neurocritical Care - December 9, 2014 Category: Neurology Source Type: research

Delay in Diagnosis of Basilar Artery Stroke
Conclusions Our results suggest that both pre-hospital and in-hospital processes cause substantial, clinically significant delays in the diagnosis of BA stroke.
Source: Neurocritical Care - October 26, 2015 Category: Neurology Source Type: research

Diagnostic Accuracy of Glial Fibrillary Acidic Protein and Ubiquitin Carboxy - Terminal Hydrolase - L1 Serum Concentrations for Differentiating Acute Intracerebral Hemorrhage from Ischemic Stroke
ConclusionsGFAP may differentiate ICH from ischemic stroke and stroke mimics. A point-of-care test to distinguish between ischemic and hemorrhagic strokes might facilitate triage to different treatment pathways or locations, or be used to select patients for trials of ultra-early interventions.
Source: Neurocritical Care - February 23, 2020 Category: Neurology Source Type: research

Anticoagulation use and Hemorrhagic Stroke in SARS-CoV-2 Patients Treated at a New York Healthcare System
ConclusionWe observed an overall low rate of imaging-confirmed hemorrhagic stroke among patients hospitalized with COVID-19. Most hemorrhages in patients with COVID-19 infection occurred in the setting of therapeutic anticoagulation and were associated with increased mortality. Further studies are needed to evaluate the safety and efficacy of therapeutic anticoagulation in patients with COVID-19.
Source: Neurocritical Care - August 23, 2020 Category: Neurology Source Type: research

Hospital Length of Stay and 30-Day Mortality Prediction in Stroke: A Machine Learning Analysis of 17,000 ICU Admissions in Brazil
ConclusionsHospital length of stay and 30-day mortality of patients admitted to the ICU with stroke were accurately predicted through machine learning methods, even in the absence of stroke-specific data, such as the National Institutes of Health Stroke Scale score or neuroimaging findings. The proposed methods using general intensive care databases may be used for resource use allocation planning and performance assessment of ICUs treating stroke. More detailed acute neurological and management data, as well as long-term functional outcomes, may improve the accuracy and applicability of future machine-learning-based prediction algorithms.
Source: Neurocritical Care - April 6, 2022 Category: Neurology Source Type: research

Initial Conservative Management of Severe Hemispheric Stroke Reduces Decompressive Craniectomy Rates
Conclusions Delayed DC for hemispheric stroke patients managed under protocol in the neurocritical care unit is a safe alternative to early, prophylactic DC for adults with severe hemispheric stroke. This strategy reduced DC rates by 60 % without an excess of death or survival with severe disabilities.
Source: Neurocritical Care - April 20, 2016 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

Stroke and Intracranial Hemorrhage in HeartMate II and HeartWare Left Ventricular Assist Devices: A Systematic Review
ConclusionsIschemic stroke and ICH are common after LVAD placement, but heterogeneous event rates are reported in the literature. Given the high associated mortality, further prospective study is warranted.
Source: Neurocritical Care - July 25, 2017 Category: Neurology Source Type: research

Preventing Chronic Emotional Distress in Stroke Survivors and Their Informal Caregivers
ConclusionsThe challenges and impacts of stroke most commonly reported by dyads were: uncertainty about future health, fear of recurrent strokes, negative emotions, and role changes post-stroke. Dyads and nurses agreed that resiliency skills such as mindfulness/focusing on the present, problem solving, gratitude/optimism, self-care, interpersonal communication and developing a supportive team of family, friends, and medical staff are beneficial to optimize recovery. The potential barrier to intervention delivery was accessibility, due to challenges of time and travel to appointments. Participants agreed that starting the i...
Source: Neurocritical Care - November 12, 2018 Category: Neurology Source Type: research

A Unique Signature of Cardiac-Induced Cranial Forces During Acute Large Vessel Stroke and Development of a Predictive Model
ConclusionsHeadpulse recordings performed on patients with suspected acute stroke significantly identify those with LVO. The lack of temporal correlation of the headpulse with cardiac contraction and resolution to normal may reflect changes in cerebral blood flow and may provide a useful technique to triage stroke patients for thrombectomy using a noninvasive device.
Source: Neurocritical Care - October 6, 2019 Category: Neurology Source Type: research

Outcomes of Acute Stroke Patients Requiring Mechanical Ventilation: Study Protocol for the SPICE Multicenter Prospective Observational Study
ConclusionsThe SPICE multicenter study will investigate 1-year outcomes, ethical issues, as well as care pathways of acute stroke patients requiring invasive ventilation in the ICU. Gathered data will delineate human resources and facilities needs for adequate management. The identification of prognostic factors at the acute phase will help to identify patients who may benefit from prolonged intensive care and rehabilitation.Trial registration: NCT03335995.
Source: Neurocritical Care - February 4, 2020 Category: Neurology Source Type: research

Amantadine and Modafinil as Neurostimulants During Post-stroke Care: A Systematic Review
AbstractAmantadine and modafinil are neurostimulants that may improve cognitive and functional recovery post-stroke, but the existing study results vary, and no comprehensive review has been published. This systematic review describes amantadine and modafinil administration practices post-stroke, evaluates timing and impact on clinical effectiveness measures, and identifies the incidence of potential adverse drug effects. A librarian-assisted search of the MEDLINE (PubMed) and EMBASE databases identified all English-language publications with “amantadine” or “modafinil” in the title or abstract from inception throu...
Source: Neurocritical Care - May 11, 2020 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

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