Acute Cerebrovascular Conditions · Coagulopathy and Bleeding · European Guidelines · US Guidelines

Guideline for Reversal of Antithrombotics in Intracranial Hemorrhage

This guideline, issued jointly by the Neurocritical Care Society and Society of Critical Care Medicine and published in Neurocrit Care December 2015, provides timely and evidence-based reversal strategies to assist practitioners in the care of patients with antithrombotic-associated intracranial hemorrhage. Read the statement here. Best regards, Riikka Takala.

Airway Management · Systemic Effects of CNS Pathology · TBI General · Ventilation and Oxygenation

Brain Impact Apnea

Immediate apnea after acute head trauma is a concept that has received renewed focus lately. BIA/IBA (Brain Impact Apnea or as some call it, Impact Brain Apnea) was described in animal models as far back as 1874 by Koch and Filehne (1). A number of subsequent studies (2-5) have established a clear link between severity of impact and duration of… Continue reading Brain Impact Apnea

ICP/CPP management · Neuromonitoring · TBI General · Traumatic Brain Injury

BEST TRIP – ICP vs. CT/clinical exam for TBI

Now more than three years old, but still an absolute landmark study and mandatory reading for anyone who cares for neurotrauma patients. Smallish trial but very well carried out and yielding some remarkable findings. A commonly cited article by Randy Chesnut and his group showing equipoise between an ICP-driven protocol and management determined by CT… Continue reading BEST TRIP – ICP vs. CT/clinical exam for TBI

Cervical Spine Injury · Neurotrauma · Steroids · Thoracolumbar Spine Injury

Methylprednisolone and SCI

“… findings support current guidelines against routine use, but strong recommendations are not warranted because confidence in the effect estimates is limited.” Methylprednisolone for the Treatment of Patients with Acute Spinal Cord Injuries: A Systematic Review and Meta-Analysis. Evaniew et al. Journal of Neurotrauma, Feb. 2016. Link to the abstract here.