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

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 · Ischaemic Stroke · Neurovascular Surgery

Recent study in JACC – Procedure Time in Stroke Thrombectomies Has Impact on Outcomes

Endovascular thrombectomy is a cornerstone of ischaemic stroke managament. Time from stroke to intervention has been clearly linked to functional outcome (1) and is a key metric to which much attention is devoted. But what about the duration of the procedure itself? Earlier data has suggested that length of procedure may affect functional outcomes after… Continue reading Recent study in JACC – Procedure Time in Stroke Thrombectomies Has Impact on Outcomes

Acute Cerebrovascular Conditions · Ischaemic Stroke · Neuroprotection · Thermoregulation

Addition of hypothermia to decompressive hemicraniectomy is not useful in MCA stroke – JAMA

This study, recently published in JAMA, revealed no beneficial effect from hypothermia as an adjunct to decompressive hemicraniectomy in the setting of middle cerebral artery stroke. In fact, the authors’ findings even suggest harm. Find the article here.

Acute Cerebrovascular Conditions · Neurocritical Care · Neurotrauma · Scandinavian Guidelines

Best Practice Guidelines for Blunt Cerebrovascular Injuries – SJTREM

Blunt cerebrovascular injury is a relatively common finding in the traumatised patient and poses a number of clinical challenges. A Scandinavian group recently issued best practice guidelines for management of these injuries. You can find the article (free full-text) by Brommeland et al here.

Acute Cerebrovascular Conditions · Ischaemic Stroke · Neurocritical Care · US Guidelines

AHA/ASA Guidelines for Early Management of Patients with Acute Ischaemic Stroke

These guidelines were updated in 2018 and can be found here. Of special interest is the reversal of the recommendation to avoid general anaesthesia for thrombectomy in stroke, in view of newer data. The choice of conscious sedation versus GA should be individualised and are both approaches are acceptable, according to the revised guidelines. More on… Continue reading AHA/ASA Guidelines for Early Management of Patients with Acute Ischaemic Stroke

Acute Cerebrovascular Conditions · Basic Sciences & Physiology · Neurocritical Care · Neuromonitoring · Neuroprotection

Lactate Improves Cerebral Perfusion After Acute Brain Injury – Recent Clinical Trial in Crit Care Med

Lactate is well-known as an important energy substrate for brain tissue and plays a key role in neuroenergetics. Experimental data have shown that exogenous lactate administration may improve metabolism in injured brain cells, and possibly has neuroprotective properties. Till now there has been a paucity of human clinical studies on this subject. Carteron et al… Continue reading Lactate Improves Cerebral Perfusion After Acute Brain Injury – Recent Clinical Trial in Crit Care Med