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.
Recently published in the Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine by Hov et al. This article relays two case reports on successful diagnosis of SAH in a prehospital setting using a mobile CT unit. As the article reveals, this could entail significantly shortened time to meaningful intervention at a neurosurgical center, especially in… Continue reading SJTREM – Prehospital CT for Diagnosing SAH
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
Published in 2011 by Schmidt et al (free full-text in Stroke), this article looks at CPP thresholds for cerebral hypoxia in SAH patients. They went through multimodal monitoring data for 30 patients with poor-grade SAH. Using microdialysis and brain tissue oxygenation as their main determinants of hypoxia, they found that patients with a CPP <70… Continue reading Cerebral Perfusion Pressure Thresholds for Brain Tissue Hypoxia and Metabolic Crisis After Poor-Grade Subarachnoid Hemorrhage
Right off the press: an open access review article from Critical Care on fluid therapy in the neurological patient. It provides a nice synopsis of the different fluid therapy paradigms that are advocated through various guidelines. The review challenges some of the tenets of basic treatment, such as empirical fluid maintenance and the definition of… Continue reading Critical Care: Fluid Therapy in Neurological Patients
Systematic review, Cochrane march 2016. Li et al. Intraoperative mild hypothermia for postoperative neurological deficits in people with intracranial aneurysm. The authors did not identify any reliable evidence to support the routine use of intraoperative mild hypothermia. Read more here.
A very worthwhile and insightful overview of SAH management in the acute phase. Courtesy of Continuing Education in Anaesthesia, Critical Care & Pain. Read it here.