Category: Subarachnoid Haemorrhage

Acute Cerebrovascular Conditions · Air Embolism · Aneurysm Surgery · Cervical Spine Surgery · General Topics · Haemodynamics · ICP/CPP management · Intracranial Surgery General · Ischaemic Stroke · Neuroanaesthesia · Neuromonitoring · Neurovascular Surgery · Perioperative Management · Sedation · Seizure Control · Subarachnoid Haemorrhage · Thoracolumbar Spine Surgery · US Guidelines · Ventilation and Oxygenation

SNACC – How to Handle Neuroanaesthetic Emergencies

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From our quality-focused colleagues at the Society for Neuroscience in Anesthesiology and Critical Care (SNACC) comes this set of guidelines for management of the most common emergencies encountered in neuroanaesthetic practice. Conceived with the purpose of addressing complex emergent issues in a concise, goal-directed and simplified manner, these cognitive aids are clear-cut and based on… Continue reading SNACC – How to Handle Neuroanaesthetic Emergencies

Acute Cerebrovascular Conditions · discussions · Intracerebral Haemorrhage · Ischaemic Stroke · Neurocritical Care · Neuromonitoring · Neurotrauma · Subarachnoid Haemorrhage · Traumatic Brain Injury

Meyfroidt et al in ICM: Ten false beliefs in neurocritical care

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Meyfroidt and colleagues recently published a commentary in Intensive Care Medicine addressing ten tenets in neurocritical care that merit debate. The article deals with the following ten statements: 1. Only neurointensivists should care about the brain. 2. Clinical examination of neurocritically ill patients is impossible. 3. We should no longer monitor ICP in traumatic brain… Continue reading Meyfroidt et al in ICM: Ten false beliefs in neurocritical care

Acute Cerebrovascular Conditions · Coagulopathy and Bleeding · Intracerebral Haemorrhage · Pharmacology · Subarachnoid Haemorrhage

TICH-2: No Benefit From TXA in ICH. What Now?

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Tranexamic acid (TXA) has been held as something of a wonder drug. It’s cheap, largely demonstrated to be safe and has been given a role in a number of settings. The 2013 CRASH-2 trial showed improved survival in trauma with bleeding, and thus became one of the most widely cited publications in traumatology and emergency medicine. Several… Continue reading TICH-2: No Benefit From TXA in ICH. What Now?

Acute Cerebrovascular Conditions · European Guidelines · Fluid Management · Haemodynamics · Osmotherapy · Subarachnoid Haemorrhage · Traumatic Brain Injury

Fluid Therapy in Neurointensive Care patients – An ESICM Recommendation

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Just published: the European Society of Intensive Care Medicine´s consensus document on fluid administration in the NICU. It covers all manner of neurocritical conditions and sums up the available evidence for various fluid therapy approaches. As expected there are few recommendations that aren´t already well established and by now fairly uncontroversial (multimodal monitoring, avoiding colloids,… Continue reading Fluid Therapy in Neurointensive Care patients – An ESICM Recommendation

Acute Cerebrovascular Conditions · Subarachnoid Haemorrhage

SJTREM – Prehospital CT for Diagnosing SAH

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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

Acute Cerebrovascular Conditions · EEG · Neuromonitoring · Subarachnoid Haemorrhage

EEG and Oxygenation in Acute Brain Injury

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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

Acute Cerebrovascular Conditions · Haemodynamics · Neuromonitoring · Subarachnoid Haemorrhage

Cerebral Perfusion Pressure Thresholds for Brain Tissue Hypoxia and Metabolic Crisis After Poor-Grade Subarachnoid Hemorrhage

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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