Neurotrauma · Paediatrics · Scandinavian Guidelines · TBI General · Traumatic Brain Injury

The SHIPP Study: Scandinavian Head Injury Trial in Paediatric Patients

Do you work in a centre that manages head injuries in paediatric patients? The SHIPP trial is a pragmatic, prospective, multicentre study for the validation of the Scandinavian guidelines for minor and moderate head trauma in children. Currently the trial group is actively recruiting participant centres in Scandinavia. Any centre in Norway, Finland, Sweden or… Continue reading The SHIPP Study: Scandinavian Head Injury Trial in Paediatric Patients

ICP/CPP management · Neurocritical Care · Neuromonitoring · Neurotrauma · TBI General · Traumatic Brain Injury · US Guidelines

SIBICC: Management Algorithm for TBI-patients with both PbtO2 and ICP-monitoring

The Seattle International Severe Traumatic Brain Injury Consensus Conference (SIBICC) recently released a superb article detailing the recommended treatment approach in TBI-patients with both cerebral tissue oximetry and ICP-monitoring. It provides an easy-to-follow and logical multi-tier algorithm for addressing various combinations of ICP/PbtO2 abnormalities. As such it offers a guidance document for clinical care that… Continue reading SIBICC: Management Algorithm for TBI-patients with both PbtO2 and ICP-monitoring

Acute Cerebrovascular Conditions · European Guidelines · Intracerebral Haemorrhage · Ischaemic Stroke · Neurocritical Care · Neurotrauma · Traumatic Brain Injury · UK Guidelines

Joint AAGBI & NACCS Guidelines on Safe Transfer of the Brain Injured Patient

In December 2019 the Association of Anaesthetists and the Neuro Anaesthesia and Critical Care Society and the Neuro Anaesthesia and Critical Care Society published their joint guidelines on how to safely transfer patients with acute brain injury to the appropriate level of care. Focusing on TBI and stroke-related brain injury, this consensus document outlines both… Continue reading Joint AAGBI & NACCS Guidelines on Safe Transfer of the Brain Injured Patient

Analgaesia · Awake Craniotomy · Cervical Spine Surgery · Ischaemic Stroke · Neuroanaesthesia · Neuromonitoring · Perioperative Management · Thoracolumbar Spine Surgery · Ventilation and Oxygenation

Neuroanaesthesia Special in the October Edition of Current Opinion in Anaesthesiology

This month’s edition of Current Opinion in Anaesthesiology is replete with neuro-topics, ranging from awake craniotomy to complex spinal surgery and anaesthesia for stroke thrombectomy. Well worth a read, this collection of articles provides (often excellent) summaries of evidence and current practice in numerous fields relevant to the neuroanaesthetist.

Cervical Spine Injury · Neuroprotection · Neurotrauma · Scandinavian Guidelines · Thoracolumbar Spine Injury

New Danish Guidelines on Spinal Stabilisation in Trauma

Our Danish colleagues have recently issued updated guidelines on spinal stabilisation of adult trauma patients (open-access in the Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine). As expected, the evidence base is fairly limited as robust randomised studies on this topic are rare and often hard to conduct. The group does provide a strong recommendation… Continue reading New Danish Guidelines on Spinal Stabilisation in Trauma

ICP/CPP management · Neurocritical Care · Neurotrauma · Osmotherapy · Traumatic Brain Injury

Mannitol vs. Hypertonic Saline in TBI – A Retrospective Study

The optimal hyperosmotic agent for treatment of intracranial hypertension following TBI has been an inexhaustible subject of debate. Scant evidence underlies these discussions despite widespread and long-standing use of both agents. In this article Anstey et al. retrospectively analysed data from 14 different centres to compare outcomes in mannitol-only and hypertonic saline-only cohorts. They excluded… Continue reading Mannitol vs. Hypertonic Saline in TBI – A Retrospective Study

Basic Sciences & Physiology · Cardiovascular Conditions · General Topics · Haemodynamics · Neuroanaesthesia · Pharmacology · Traumatic Brain Injury

SNACC.org – Article of the Month: Effects of Vasopressors on Cerebral Circulation and Oxygenation

SNACC’s article of the month for July is an excellent narrative review on the pharmacodynamics of vasopressors in health and in the setting of brain injury. The review is preceded by an introductory commentary by neuroscand.com contributor Dr. Riikka Takala.

Acute Cerebrovascular Conditions · Intracerebral Haemorrhage · Neurocritical Care · Neurovascular Surgery

ATACH II Follow-up Subgroup Analysis: Intensive BP Reduction Reduces Expansion of Deep ICH, But No Difference in Functional Outcome

The landmark 2016 ATACH II trial compared aggressive blood pressure lowering (110-139 mmHg) with standard BP-targets (140-180) in patients with spontaneous ICH, and found no difference between the groups. The main endpoints were mortality and functional neurological outcome (modified Rankin scale). The only discernible difference was a tendency towards less haematoma expansion in the intervention… Continue reading ATACH II Follow-up Subgroup Analysis: Intensive BP Reduction Reduces Expansion of Deep ICH, But No Difference in Functional Outcome

Acute Cerebrovascular Conditions · Cardiovascular Conditions · Haemodynamics · Intracerebral Haemorrhage · Neurocritical Care · Systemic Effects of CNS Pathology

Cardiovascular Abnormalities in ICH – a Narrative Review

Intracerebral haemorrhage is associated with a number of haemodynamic consequences. These are not just limited to arrhythmias. Lele and colleagues have summarised the most common and important ones in this review in the Journal of Neurosurgical Anesthesiology.