Brain impact apnoea causes secondary brain injury. The duration of the apnoea reflects the energy in the injury. We often see these patients in our trauma center as they come intubated. CT-scan can reveal structural brain damage or bleeding. In some pastients the CT-scan is “normal”. However, the brain may have suffered hypoxic injuries undetectable with… Continue reading More Brain Impact Apnoea
Results from the HYBERNATUS trial were just published in the New England Journal of Medicine by Legriel et al. This study recruited 270 patients with convulsive status epilepticus, randomized to either therapeutic hypothermia (32-34 C) or normothermia. All patients were intubated and on controlled ventilation when included. All received standard antiepileptic pharmacological treatment. Primary outcome… Continue reading HYBERNATUS Trial: Hypothermia Not Associated With Better Outcomes in Status Epilepticus
It is widely accepted that hypotension in patients with traumatic brain injury is associated with poorer outcomes, as confirmed in a number of studies. But is there really a reliable cut-off for when we should be happy with a TBI patient´s blood pressure in a prehospital setting? A recent article in JAMA Surgery (Spaite et… Continue reading Prehospital BP and Mortality in TBI: Time to Reevaluate Our Haemodynamic Targets?
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
A very structured and useful approach to dealing with the undifferentiated comatose patient in the ER. EMCrit´s Scott Weingart interviews neurocritical care heavy-hitter Dr. Eelco Wijdicks of the Mayo Clinic. You can find the podcast here, together with handy show notes. I especially appreciate the focus on the Four Score as an adjunct to the Glasgow Coma… Continue reading EMCrit podcast: Coma By Eelco Wijdicks
A thought provoking take on death by neurological criteria, challenging the traditionally accepted concept of brain death. Listen to the talk from SMACC DUB here.
Watch this lecture by Michael Avidan, Washington University School of Medicine. Introduction and clinical use of EEG. Another resource are the learning modules of Partners Healthcare. Register for free at www.anesthesiaeeg.com.
Ivan came across this very useful and reasonably understandable introduction to EEG monitoring for anaesthetic use. It´s put together by the guys at ICETAP (International Consortium for EEG Training of Anesthesia Practitioners). It´s part of a series of tutorials on all things EEG for complete novices.
Follow the link to read the article: http://jamanetwork.com/journals/jama/fullarticle/2577957
Brain Trauma Foundation has just published the 4th edition of Guidelines for the Management of Severe TBI. Study the guidelines here.
neuroscand.com 