Excellent review of asssessment of cerebral circulation by Donnelly et al. in Critical Care May 2016. The authors go through most of today’s available modalities and review their utility in neurocritical care. Find the article here.
Really interesting article in the latest issue of JAMA Neurology: Specific EEG changes, known as periodic discharges (PDs), seem to be of value in predicting brain tissue hypoxia in vulnerable patients with acute brain injury. In this investigation, Witsch and colleagues included 90 patients with high-grade subarachnoid haemorrhage and monitored them with continuous EEG in addition to… Continue reading EEG and Oxygenation in Acute Brain Injury
Just published in the Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine as an open-access article: The Norwegian guidelines for the prehospital management of adult trauma patients with potential spinal injury by Kornhall et al. The result of a critical review of the available evidence by a multidisciplinary group of clinicians, these guidelines wrestle with many of… Continue reading New Norwegian Prehospital Spinal Injury Guidelines
Results from the HYBERNATUS trial were just published in the New England Journal of Medicine by Legriel et al. This study recruited 270 patients with convulsive status epilepticus, randomized to either therapeutic hypothermia (32-34 C) or normothermia. All patients were intubated and on controlled ventilation when included. All received standard antiepileptic pharmacological treatment. Primary outcome… Continue reading HYBERNATUS Trial: Hypothermia Not Associated With Better Outcomes in Status Epilepticus
It is widely accepted that hypotension in patients with traumatic brain injury is associated with poorer outcomes, as confirmed in a number of studies. But is there really a reliable cut-off for when we should be happy with a TBI patient´s blood pressure in a prehospital setting? A recent article in JAMA Surgery (Spaite et… Continue reading Prehospital BP and Mortality in TBI: Time to Reevaluate Our Haemodynamic Targets?
Published in 2015: American Heart Association/American Stroke Association Focused Update of the 2013 Guidelines for the Early Management of Patients With Acute Ischemic Stroke Regarding Endovascular Treatment. Available here. It acknowledges that a stronger recommendation for the use of endovascular thrombectomy can now be made. This is based on a number of studies suggesting benefit with these… Continue reading AHA/ASA Guidelines on Ischemic Stroke
A very structured and useful approach to dealing with the undifferentiated comatose patient in the ER. EMCrit´s Scott Weingart interviews neurocritical care heavy-hitter Dr. Eelco Wijdicks of the Mayo Clinic. You can find the podcast here, together with handy show notes. I especially appreciate the focus on the Four Score as an adjunct to the Glasgow Coma… Continue reading EMCrit podcast: Coma By Eelco Wijdicks
A thought provoking take on death by neurological criteria, challenging the traditionally accepted concept of brain death. Listen to the talk from SMACC DUB here.
Ivan came across this very useful and reasonably understandable introduction to EEG monitoring for anaesthetic use. It´s put together by the guys at ICETAP (International Consortium for EEG Training of Anesthesia Practitioners). It´s part of a series of tutorials on all things EEG for complete novices.
After completing recruitment of some 408 TBI patients in 2014, the RESCUEicp group finally published the results from this eagerly awaited trial. The article by Hutchinson et al, titled Trial of Decompressive Craniectomy for Traumatic Intracranial Hypertension, was published on September 7th in the New England Journal of Medicine. So let´s go straight to the core: The study… Continue reading RESCUEicp Trial Results Finally Out: Craniectomy in TBI Lowers Mortality, But Survivors Suffer Worse Neurological Outcomes
neuroscand.com 