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?
Excellent and widely read overview of sedation regimes in acute brain injury. Find the article by Oddo et al in Critical Care here.
From our fellow anaesthetist Lars Prag Antonsen comes this eye-opening essay on cognitive processes and how we apply them in high-pressure settings. Very relevant for anaesthetic practice as well as being an enjoyable read. Find the full-text article in the Journal of the Norwegian Medical Association here.
A recently published review  by our Danish colleagues sums up the more recent trials on the subject of anaesthetic technique for endovascular treatments of ischaemic stroke. Previous publications, many of which are based largely on observational or retrospective data, have suggested harm from general anaesthesia (GA) for these procedures, when compared with conscious sedation… Continue reading Anaesthesia for Endovascular Treatment of Acute Ischaemic Stroke: Still Controversial?
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
Subarachnoid Hemorrhage International Trialists (SAHIT) scoring system. Also see the following article i the BMJ: Development and validation of outcome prediction models for aneurysmal subarachnoid haemorrhage: the SAHIT multinational cohort study.
Christmas and New Years is usually fairly dormant in terms of publications, but a few worth mentioning have surfaced. This recent meta-analysis of gabapentin as an analgaesic adjunct in spinal surgery was published in Pain Physician by Han et al. The group included 10 trials, covering 827 patients, and found significantly reduced postoperative morphine consumption,… Continue reading Gabapentin and Spinal Surgery – a Meta-analysis
In the last issue of Journal of neurosurgical anesthesiology, there is an interesting article discussing elevated serum lactate during craniotomies. Brallier et al performed a retrospective cohort study of elective adult craniotomy cases (436 patients). They found that elevated intraoperative serum lactate in craniotomy patients is associated with new neurological deficits (odds ratio, 2.11) and longer length… Continue reading Elevated serum lactate during craniotomies…
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.