We all recall the elegant curves that ostensibly show the neat relationship between mean arterial blood pressure (or CPP) and cerebral blood flow. This relationship classically has its lower and upper limits, beyond which CBF will vary passively with the systemic pressure. Stay within these limits and all is good, the mantra goes. However, as… Continue reading Cerebral Autoregulation – What do we know?
Targeted temperature management (TTM) as a neuroptotective strategy is applied in a number of scenarios; post-ROSC in cardiac arrest, neonatal asphyxia, traumatic brain injury, to name some. The Neurocritical Care Society have taken it upon themselves to formulate an evidence-based guideline to the implementation and practical management of TTM in a number of settings. Although… Continue reading TTM – New Guidelines from NCS
This is a subject that has been on our backburner for a while and it’s now due for a discussion on neuroscand.com. The use of beta-blockers in traumatic brain injury is nothing new. The indications have been largely centered on targeting and preventing paroxysmal sympathetic hyperactivity (PSH) and associated post-TBI autonomic phenomena. Please see our… Continue reading Beta-blockers and TBI
Here’s a few resources on anaesthesia for awake craniotomies that have recently come to our attention, thanks to some of our colleagues: The first, from UpToDate, was updated this year. The second is part of the British Journal of Anaesthesia’s Continuing Education in Anaesthesia Critical Care & Pain series. It dates back to 2013 but is still… Continue reading Awake Craniotomy: Useful Resources
The world of medical publishing is waking up from its summer slumber and a host of good neurology articles have been released lately. And here’s one on SAH from NEJM’s clinical practice series. A nice and easily read synopsis on the subject. Can be found here.
We have probably all struggled with these phenomena in our TBI patients in the neuro ICU: swinging blood pressures, episodic tachycardia and fever, occurring even several weeks after the initial traumatic event. In this article in the Lancet, Meyfroidt and colleagues offer us some insight into the clinical syndrome now known as paroxysmal sympathetic hyperreactivity.… Continue reading Lancet: Paroxysmal Sympathetic Hyperactivity after TBI – An Underrecognized Clinical Entity
In this article Swedish and Finnish colleagues (Thelin et al) look at current scoring systems for CT imaging in TBI patients. Most older systems in use today seem to be increasingly outdated and are limited in their diagnostic and prognostic accuracy. It is the latter the authors seem to focus on in this observational multicenter… Continue reading New Article in PLOS: Reevaluating CT Scoring Systems for TBI