Acute Cerebrovascular Conditions · 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

Acute Cerebrovascular Conditions · US Guidelines

AHA/ASA Guidelines on Ischemic Stroke

Published in 2015: American Heart Association/American Stroke Association Focused Update of the 2013 Guidelines for the Early Management of Patients With Acute Ischemic Stroke Regarding Endovascular Treatment. Available here. It acknowledges that a stronger recommendation for the use of endovascular thrombectomy can now be made. This is based on a number of studies suggesting benefit with these… Continue reading AHA/ASA Guidelines on Ischemic Stroke

Acute Cerebrovascular Conditions · Haemodynamics · Neuromonitoring · Subarachnoid Haemorrhage

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

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