Coagulopathy and Bleeding · Neurocritical Care · Neurotrauma · TBI General · Traumatic Brain Injury

Impact of DOACs in TBI in the over 60s

The ever-increasing use of direct (or novel) oral anticoagulants (DOACs) has had a profound effect on primary and secondary prevention of thromboembolic events, especially in the elderly. Whilst many patients benefit from switching over to these newer drugs from older anticoagulants like warfarin, thus foregoing such nuisances as INR-guided dosing, they have also inevitably led… Continue reading Impact of DOACs in TBI in the over 60s

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

Fluid Management · Neuroanaesthesia · Osmotherapy · Paediatrics · Perioperative Management

Balanced Crystalloids Better Than Isotonic Saline for Craniotomy in Kids?

In this interesting trial by Lima and colleagues, with findings published recently in the Journal of Neurosurgical Anesthesiology, the authors compare normal saline (NS) with a balanced crystalloid as a maintenance fluid for elective tumour resection in paediatric patients. Their main endpoint was change in serum chloride from baseline to end of surgery. Perhaps unsurprisingly… Continue reading Balanced Crystalloids Better Than Isotonic Saline for Craniotomy in Kids?

Neurocritical Care · Neurotrauma · Paediatrics · Traumatic Brain Injury · US Guidelines

BTF Guidelines for Paediatric TBI 2019 – Finally Updated

In a long overdue update, the Brain Trauma Foundation have issued their recently revised guidelines for management of paediatric severe traumatic brain injury. We at neuroscand.com have yet to assess all of the recommendations yet, so expect more as we get through the whole document. At first glance, though, there seems to be little substantial… Continue reading BTF Guidelines for Paediatric TBI 2019 – Finally Updated

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.

Neurocritical Care · Neuroprotection · Neurotrauma · Traumatic Brain Injury

Glycaemic Control Targets After Traumatic Brain Injury: A Systematic Review and Meta-analysis

Hermanides and colleagues recently reviewed all available evidence on blood glucose targets in the TBI patient. Read their finding in this article in Critical Care. When comparing strict glycaemic regimens with more liberal strategies they found no significant differences in patient-important outcomes, contrary to earlier findings. They did reveal an increased risk of hypoglycaemia, however.… Continue reading Glycaemic Control Targets After Traumatic Brain Injury: A Systematic Review and Meta-analysis

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.