Abstract：
INTRODUCTION:The incidence of spinal epidural abscesses (SEAs) is rising. Although increased awareness has led to decreased mortality, morbidity remains unacceptably high, with rapid deterioration of neurological status when there is a delay in initiation of treatment. Therefore, we need to build a better understanding of prognostic factors and management strategies. The goal of this article is to identify various prognostic factors, the role of inflammatory markers, optimal management strategies, and the relationship between timing of intervention and outcome. METHODS:A computer search of health records in our institution revealed 20 cases of spinal epidural abscess over the past 5 years. A retrospective analysis of clinical, radiological, laboratory, and surgical findings was performed. A scoring system ranging from 1 (complete neurological recovery) to 5 (dead) was used to assess outcomes. We also analyzed the prognostic value of several factors, including demographics, clinical presentation, comorbidities, inflammatory markers, imaging findings, and timing of intervention. RESULTS:Fifteen of 20 patients had a good outcome (score of 1 or 2) in this series. Erythrocyte sedimentation rate, muscle strength at time of admission, and timing of intervention were found to have a statistically significant relationship with outcome. C-reactive protein, comorbidities, age, sex, and degree of thecal sac compression were found to have no prognostic value. CONCLUSION:Although many prognostic factors have been suggested and analyzed, the most important contributor to outcome in SEA remains a high clinical suspicion, prompt investigation, and immediate intervention.
journal_name
Neurocrit Carejournal_title
Neurocritical careauthors
Kumar K,Hunter Gdoi
10.1385/NCC:2:3:245keywords:
subject
Has Abstractpub_date
2005-01-01 00:00:00pages
245-51issue
3eissn
1541-6933issn
1556-0961pii
NCC:2:3:245journal_volume
2pub_type
杂志文章abstract：BACKGROUND:Takotsubo syndrome is a reversible neuromyocardial failure that has been thought to be related to an acute catecholamine toxicity of the myocardium brought upon by a stressful event. The neurocritical care unit population is particularly vulnerable for this condition given the acute presentation of neurologi...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-008-9075-x
更新日期：2008-01-01 00:00:00
abstract：INTRODUCTION:Spinal cord ischemia and stroke are recognized complications of descending thoracic (DTA) and thoracoabdominal aortic (TAA) operations. However, there are limited data available on outcomes since the advent of thoracic endovascular aortic repair (TEVAR). METHODS:We reviewed charts from consecutive patient...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-008-9104-9
更新日期：2008-01-01 00:00:00
abstract：:Subarachnoid hemorrhage (SAH) is a neurological emergency because it may lead to sudden neurological decline and death and, depending on the cause, has treatment options that can return a patient to normal. Because there are interventions that can be life-saving in the first hour of onset, SAH was chosen as an Emergen...
journal_title：Neurocritical care
pub_type： 杂志文章,评审
doi：10.1007/s12028-012-9761-6
更新日期：2012-09-01 00:00:00
abstract：:Prophylactic use of hypervolemia and hypertension is believed to present an option to decrease the incidence of symptomatic vasospasm after aneurysmal subarachnoid hemorrhage and improve neurologic outcome. A Medline literature search was conducted to review available evidence regarding volume management after subarac...
journal_title：Neurocritical care
pub_type： 杂志文章,评审
doi：10.1007/s12028-011-9593-9
更新日期：2011-09-01 00:00:00
abstract：BACKGROUND:This study investigated if cerebral blood flow (CBF) regulation by changes of the arterial partial pressure of carbon dioxide (PaCO2) can be used therapeutically to increase CBF and improve neurological outcome after subarachnoid hemorrhage (SAH). METHODS:In 12 mechanically ventilated poor-grade SAH-patient...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-016-0246-x
更新日期：2016-10-01 00:00:00
abstract：:Diagnosis of an intracranial aneurysm during pregnancy is a rare event requiring multidisciplinary care for successful management. The knowledge base for the anesthesiologist involves principles of both obstetric and neuroanesthesia, as well as critical care. This article reports such a case and discusses the relevant...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1385/NCC:4:1:018
更新日期：2006-01-01 00:00:00
abstract：:Sleep is fundamental for everyday functioning, yet it is often negatively impacted in critically ill patients by the intensive care setting. With a focus on the neurological intensive care unit (NeuroICU), this narrative review summarizes methods of measuring sleep and addresses common causes of sleep disturbance in t...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-019-00795-4
更新日期：2020-04-01 00:00:00
abstract：INTRODUCTION:A 38-year-old man with severe head trauma complicated by paroxysmal severe intracranial pressure elevation associated with tachypnea, tachycardia, diaphoresis, and extensor posturing was diagnosed as suffering from paroxysmal autonomic instability with dystonia (PAID). These events were unresponsive to sta...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-007-0066-0
更新日期：2007-01-01 00:00:00
abstract：BACKGROUND:Acute hydrocephalus is a common complication of aneurysmal subarachnoid hemorrhage (aSAH); however, attempts to predict shunt-dependent chronic hydrocephalus using clinical parameters have been equivocal. METHODS:Cohort study of aSAH is treated with external ventricular drainage (EVD) placement at our insti...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-019-00886-2
更新日期：2020-08-01 00:00:00
abstract：: ...
journal_title：Neurocritical care
pub_type： 评论,信件
doi：10.1007/s12028-018-0605-x
更新日期：2018-12-01 00:00:00
abstract：INTRODUCTION:Methylene blue (MB) infusion is frequently used to localize the parathyroid glands during parathyroidectomy and generally considered safe. Several recent reports suggest neurological toxicity and post-operative altered mental state typically after large dose infusions. The mechanism by which MB has neuroto...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-009-9206-z
更新日期：2009-01-01 00:00:00
abstract：BACKGROUND:Early diagnostic orientation for differentiating pneumonia from pneumonitis at the early stage after aspiration would be valuable to avoid unnecessary antibiotic therapy. We assessed the accuracy of procalcitonin (PCT) in diagnosing aspiration pneumonia (AP) in intensive care unit (ICU) patients requiring me...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-018-0623-8
更新日期：2019-04-01 00:00:00
abstract：BACKGROUND:During late pregnancy and the puerperium cerebral venous and sinus thrombosis (CVST) is a rare but important cause of stroke. Despite adequate anticoagulation some patients deteriorate, which may warrant the use of more aggressive treatment modalities. CASE REPORT:A 29-year-old pregnant woman (29th week of ...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-010-9389-3
更新日期：2011-08-01 00:00:00
abstract：BACKGROUND:The indications for bevacizumab (a vascular endothelial growth factor inhibitor) have been expanded recently. Despite concerns for cerebrovascular events from bevacizumab treatment, detailed clinical and radiologic information are lacking. METHODS:Using the Mayo Clinic Rochester database (January 2006-Septe...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-011-9552-5
更新日期：2011-12-01 00:00:00
abstract：INTRODUCTION:Delayed ischemic neurologic deficits secondary to vasospasm are a major cause of morbidity and mortality after subarachnoid hemorrhage (SAH). Treatment of vasospasm after SAH is associated with complications, and reliable techniques for evaluating effects of treatment of vasospasm in such patients are warr...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1385/ncc:6:1:40
更新日期：2007-01-01 00:00:00
abstract：:Advanced hemodynamic monitoring is necessary for many patients with acute brain and/or spinal cord injury. Optimizing cerebral and systemic physiology requires multi-organ system function monitoring. Hemodynamic manipulations are cardinal among interventions to regulate cerebral perfusion pressure and cerebral blood f...
journal_title：Neurocritical care
pub_type： 杂志文章,评审
doi：10.1007/s12028-011-9568-x
更新日期：2012-02-01 00:00:00
abstract：BACKGROUND:Global cerebral edema (GCE) with subsequent refractory intracranial hypertension complicates some cases of aneurysmal subarachnoid hemorrhage (aSAH), and typically is associated with poorer outcome. Treatment options for refractory intracranial pressure (ICP) cases are limited to decompressive hemicraniectom...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-014-9989-4
更新日期：2014-12-01 00:00:00
abstract：BACKGROUND:The aim of this study is to determine the utility of non-invasive bedside neuromonitoring, including cerebral regional oxygen saturation (rSO2) measured by near-infrared spectroscopy and serum biomarkers, in identifying children at risk from adverse neurological outcome after heart surgery. METHODS:Prospect...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-013-9934-y
更新日期：2014-08-01 00:00:00
abstract：:This review examines the available data on the use of osmotic agents in patients with head injury and ischemic stroke, summarizes the physiological effects of osmotic agents, and presents the leading hypotheses regarding the mechanism by which they reduce ICP. Finally, it addresses the validity of the following common...
journal_title：Neurocritical care
pub_type： 杂志文章,评审
doi：10.1385/NCC:1:2:219
更新日期：2004-01-01 00:00:00
abstract：INTRODUCTION:Relative adrenal insufficiency has been shown to occur in the settings of critical illness and septic shock, impairing the body's ability to respond to stress. Studies have demonstrated that the treatment of adrenal insufficiency (AI) results in shock reversal, hemodynamic stability, and a subsequent decre...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-007-9003-5
更新日期：2008-01-01 00:00:00
abstract：BACKGROUND:Fever is associated with worse outcome after intracerebral hemorrhage (ICH). Autonomic dysfunction, commonly seen after brain injury, results in reduced heart rate variability (HRV). We sought to investigate whether HRV was associated with the development of fever in patients with ICH. METHODS:We prospectiv...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-019-00684-w
更新日期：2019-04-01 00:00:00
abstract：BACKGROUND:Lymphopenia is increasingly recognized as a consequence of acute illness and may predispose to infections. We investigated whether admission lymphopenia (AL) is associated with increased risk of infectious complications and poor outcome in patients with spontaneous intracerebral hemorrhage (ICH). METHODS:We...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-016-0367-2
更新日期：2017-04-01 00:00:00
abstract：BACKGROUND:Cerebral edema and raised intracranial pressure are common problems in neurological intensive care. Osmotherapy, typically using mannitol or hypertonic saline (HTS), has become one of the first-line interventions. However, the literature on the use of these agents is heterogeneous and lacking in class I stud...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-010-9477-4
更新日期：2011-04-01 00:00:00
abstract：BACKGROUND AND AIMS:Lipid peroxidation represents a marker of secondary brain injury both in traumatic and in non-traumatic conditions-as in major neurosurgical procedures-eventually leading to brain edema amplification and further brain damage. Malondialdehyde (MDA), a lipid peroxidation marker, and ascorbate, a marke...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-019-00870-w
更新日期：2020-08-01 00:00:00
abstract：BACKGROUND:Physiological reactions of the stress hormone cortisol include hyperglycemia, hypertension, and endothelium dysfunction. In patients with aneurysmal subarachnoid hemorrhage (SAH), hyperglycemia, hypertension, and endothelium dysfunction are associated with the occurrence of delayed cerebral ischemia (DCI). T...
journal_title：Neurocritical care
pub_type： 杂志文章,随机对照试验
doi：10.1007/s12028-010-9331-8
更新日期：2010-06-01 00:00:00
abstract：BACKGROUND/PURPOSE:Blood type has become an increasingly recognized risk factor for coagulopathy. We explored the association between blood type and hematoma expansion (HE) after intracerebral hemorrhage (ICH). METHODS:Spontaneous ICH patients prospectively enrolled in an ongoing ICH cohort study at Columbia Universit...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-018-0655-0
更新日期：2019-08-01 00:00:00
abstract：OBJECTIVE:Identification of patients with posterior fossa infarction at risk for neurological deterioration remains a challenge. MRI-based assessments of MCA infarction can predict poor outcome. Similar quantitative imaging measures after cerebellar stroke have not been studied. We tested the hypothesis that MRI-based ...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-013-9886-2
更新日期：2013-12-01 00:00:00
abstract：BACKGROUND:The initial noncontrast computed tomography (CT) study of the head after an aneurysmal subarachnoid hemorrhage (SAH) is used to predict the risk of developing vasospasm. Changes in the extent of subarachnoid blood seen on CT images occur as a function of time after SAH, but there is no consensus on the time ...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-009-9227-7
更新日期：2009-01-01 00:00:00
abstract：BACKGROUND:Animal studies suggested that cerebral mitochondrial cardiolipin phospholipids were released after severe traumatic brain injury (TBI), contributing to the pathogenesis of thromboembolism. OBJECTIVES:To determine the incidence of anti-cardiolipin antibodies after severe TBI and whether this was related to t...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-020-01026-x
更新日期：2020-06-18 00:00:00
abstract：INTRODUCTION:Airembolism without obvious trauma or surgery is rare. METHODS:Case report. RESULTS:Four years after resection of a non-small cell lung cancer, a 57-year-old man presented with recurrent episodes of sudden onset neurological deficits. Head computer tomographic (CT) scans suggested air embolism, and furth...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-008-9073-z
更新日期：2008-01-01 00:00:00
