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

ICP/CPP management · Neurocritical Care · Neuroprotection · Neurotrauma · Thermoregulation · Traumatic Brain Injury

POLAR RCT – Don’t Worry, Thermoregulation Isn’t Dead Quite Yet

POLAR RCT is probably the most anticipated neurotrauma trial of the year and its findings were finally presented at this year’s ESICM congress in Paris. Before I comment on what POLAR RCT is all about, it’s worth taking some time to consider what this trial is NOT about. It does not deal specifically with TBI… Continue reading POLAR RCT – Don’t Worry, Thermoregulation Isn’t Dead Quite Yet

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

Coagulopathy and Bleeding · Neurotrauma · Prognostication · Traumatic Brain Injury

Predictive Factors of Traumatic Intracranial Haemorrhage in Patients on Anti-platelet Agents

It’s been a lazy summer on our part, so it’s time to get back to business. And we’ll start off with this article by Moustafa et al, which was recently published in the Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. The authors deal with the issue of predicting risk of intracranial haemorrhage in TBI patients… Continue reading Predictive Factors of Traumatic Intracranial Haemorrhage in Patients on Anti-platelet Agents

Acute Cerebrovascular Conditions · discussions · Intracerebral Haemorrhage · Ischaemic Stroke · Neurocritical Care · Neuromonitoring · Neurotrauma · Subarachnoid Haemorrhage · Traumatic Brain Injury

Meyfroidt et al in ICM: Ten false beliefs in neurocritical care

Meyfroidt and colleagues recently published a commentary in Intensive Care Medicine addressing ten tenets in neurocritical care that merit debate. The article deals with the following ten statements: 1. Only neurointensivists should care about the brain. 2. Clinical examination of neurocritically ill patients is impossible. 3. We should no longer monitor ICP in traumatic brain… Continue reading Meyfroidt et al in ICM: Ten false beliefs in neurocritical care

Acute Cerebrovascular Conditions · Coagulopathy and Bleeding · Intracerebral Haemorrhage · Subarachnoid Haemorrhage

TICH-2: No Benefit From TXA in ICH. What Now?

Tranexamic acid (TXA) has been held as something of a wonder drug. It’s cheap, largely demonstrated to be safe and has been given a role in a number of settings. The 2013 CRASH-2 trial showed improved survival in trauma with bleeding, and thus became one of the most widely cited publications in traumatology and emergency medicine. Several… Continue reading TICH-2: No Benefit From TXA in ICH. What Now?