Anaesthetic Agents · Awake Craniotomy · Neuroanaesthesia · Sedation

Awake Craniotomy: Useful Resources

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

Acute Cerebrovascular Conditions · Anaesthetic Agents · Ischaemic Stroke · Neuroanaesthesia · Sedation

AnStroke Trial: Anaesthesia vs. Sedation for Endovascular Treatment of Ischemic Stroke

Does choice of anaesthetic approach have an impact on neurological outcomes in stroke patients? This article, recently published in Stroke, examines outcomes in patients undergoing endovascular treatment for acute ischemic stroke, randomised to either conscious sedation or general anaesthesia. Retrospective material till now has suggested poorer outcomes in patients subjected to full anaesthesia when compared… Continue reading AnStroke Trial: Anaesthesia vs. Sedation for Endovascular Treatment of Ischemic Stroke

Acute Cerebrovascular Conditions · Subarachnoid Haemorrhage

SJTREM – Prehospital CT for Diagnosing SAH

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

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

Airway Management · Cervical Spine Injury · Traumatic Brain Injury

A Few Handy Resources on Airway Management

Patients with head- and neck injuries can have challenging airways. We often use videolaryngoscopes or flexible fibrescopes (single use scope) when performing intubation in such patients. Our colleagues in Copenhagen have put together a useful website with videos and other learning resources on that subject. They also arrange an annual  two-day airway course with a very extensive workshop. Read more… Continue reading A Few Handy Resources on Airway Management

Airway Management · Neurocritical Care · Neurotrauma · Traumatic Brain Injury

More Brain Impact Apnoea

Brain impact apnoea causes secondary brain injury.  The duration of the apnoea reflects the energy in the injury. We often see these patients in our trauma center as they come intubated. CT-scan can reveal structural brain damage or bleeding. In some pastients the CT-scan is “normal”. However, the brain may have suffered hypoxic injuries undetectable with… Continue reading More Brain Impact Apnoea

Airway Management · TBI General · Traumatic Brain Injury · Ventilation and Oxygenation

SJTREM: Physician Staffed EMS Associated With Improved Outcomes From TBI

In a recent article in the Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine by Pakkanen et al, retrospective data from a Finnish prehospital service is presented. They looked at prehospital management of severe TBI (severe head injury with GCS 8 or lower) over a 6-year period, including some 458 patients for analysis. They found a… Continue reading SJTREM: Physician Staffed EMS Associated With Improved Outcomes From TBI