Abstract:
:One of the most feared complications after intracranial surgery is development of acute intracranial pathology, which may result in hypoperfusion and brain injury. Thus, early neurological assessment, performed in the operating room immediately after emergence from anesthesia, is a practice that may contribute to timely diagnosis of neurosurgical complications. Failure to awake after general anesthesia precludes conductance of neurological assessment. We report a patient who failed to emerge from anesthesia after suboccipital craniotomy and had absent brain-stem reflexes with fixed and dilated pupils consistent with severe brain injury. Approximately 60 minutes after termination of surgery, the patient suddenly woke up. After the fact, we discovered that the neurosurgeon performed a generous field block with bupivacaine along the neck incision line. We presume that our patient's failure to awaken was caused by paralysis of brain-stem caused by migration of bupivacaine from the site of the injection.
journal_name
Neurocrit Carejournal_title
Neurocritical careauthors
Munis JR,Marcukaitis AW,Sprung Jdoi
10.1385/NCC:5:3:206subject
Has Abstractpub_date
2006-01-01 00:00:00pages
206-9issue
3eissn
1541-6933issn
1556-0961pii
NCC:5:3:206journal_volume
5pub_type
杂志文章abstract:BACKGROUND:The frequency and associations of spontaneous hyperventilation in subarachnoid hemorrhage (SAH) are unknown. Because hyperventilation decreases cerebral blood flow, it may exacerbate delayed cerebral ischemia (DCI) and worsen neurological outcome. METHODS:This is a retrospective analysis of data from a pros...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-015-0138-5
更新日期:2015-12-01 00:00:00
abstract:INTRODUCTION:Recent and on going clinical research trials may indicate that the incidence of vasospasm is less in patients treated with lumbar drains following SAH than with patients treated with external ventricular drainage (EVD) alone. These studies have sparked interest in the more aggressive use of LDs in patients...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-007-0047-3
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:To date, common therapy in patients with intracranial hemorrhage (ICH) includes prophylaxis of seizure using antiepileptic drugs, commonly phenytoin. Phenytoin therapy is associated with a high incidence of cognitive disturbance. Levetiracetam is known to cause less cognitive disruption and may be a suitable...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-010-9341-6
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND:Hematoma expansion after acute intracerebral hemorrhage occurs most frequently in patients presenting within 3 h of symptom onset. However, the majority of patients present outside this window or with an unknown onset time. We investigated the prevalence of hematoma expansion in these patients and assessed t...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-012-9765-2
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:The objectives of this study were to determine effects of severe traumatic brain injury (TBI) on cerebrospinal fluid (CSF) concentrations of myelin basic protein (MBP) and to assess relationships between clinical variables and CSF MBP concentrations. METHODS:We measured serial CSF MBP concentrations in chil...
journal_title:Neurocritical care
pub_type: 杂志文章,随机对照试验
doi:10.1007/s12028-012-9767-0
更新日期:2012-12-01 00:00:00
abstract:OBJECTIVES:Prophylactic treatment with antiepileptic drugs is common practice following subarachnoid hemorrhage (SAH) and traumatic brain injury. However, commonly used antiepileptic drugs have multiple drug interactions, require frequent monitoring of serum levels, and are associated with adverse effects that may prom...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1385/NCC:5:1:71
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:To investigate the effects of hyperbaric oxygen (HBO) on brain damage and autophagy levels in a rat model of middle cerebral artery occlusion. METHODS:Neurologic injury and infarcted areas were evaluated according to the modified neurological severity score and 2,3,5-triphenyltetrazolium chloride staining. ...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-018-0577-x
更新日期:2019-02-01 00:00:00
abstract:INTRODUCTION:Prompt management of aneurysmal subarachnoid hemorrhage (SAH) is critical. Literature is inconclusive regarding outcomes for patients directly admitted to specialized centers versus transferred from lower-volume hospitals. Providers are often unclear about the safety of transferring critical patients. This...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-012-9740-y
更新日期:2012-12-01 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
abstract:: ...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-018-0585-x
更新日期:2019-04-01 00:00:00
abstract:INTRODUCTION:Robotic tele-presence (RTP) is a form of mobile telemedicine, which enables a direct face-to-face rapid response by the physician, instead of the traditional telephonic paradigm. We hypothesized that a model of RTP for after-hour ICU rounds and emergencies would be associated with improved ICU nurse satisf...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-012-9712-2
更新日期:2012-08-01 00:00:00
abstract::The objective of this study was to determine the prevalence of intracranial hypertension (IHT) and the associated mortality rate in patients who suffered from primary intracerebral hemorrhage (ICH). A secondary objective was to assess predisposing factors to IHT development. We conducted a systematic literature search...
journal_title:Neurocritical care
pub_type: 杂志文章,meta分析
doi:10.1007/s12028-018-0658-x
更新日期:2019-08-01 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:BACKGROUND/OBJECTIVE:Intravenous (IV) lacosamide use for status epilepticus has increased in recent years and is recommended for refractory status epilepticus by current guidelines. Per the lacosamide package labeling, the preferred route of administration is diluted and infused over 30-60 min; however, administration ...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-018-0560-6
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Decompressive hemicraniectomy (DHC) has proven efficacious for the treatment of malignant middle cerebral artery infarction (mMCAI) only in patients less than 60 years. This study aimed to assess the effectiveness of DHC in patients up to 80. METHODS:This is a prospective, randomized, controlled trail compa...
journal_title:Neurocritical care
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1007/s12028-012-9703-3
更新日期:2012-10-01 00:00:00
abstract:INTRODUCTION:Altered mental status and more subtle cognitive and personality changes after traumatic brain injury (TBI) are pervasive problems in patients who survive initial injury. MRI is not necessarily part of the diagnostic evaluation of these patients. METHODS:Case report with relevant image and review of the li...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-012-9699-8
更新日期:2012-06-01 00:00:00
abstract:INTRODUCTION:An oculomotor palsy in the setting of aneurysmal subarachnoid hemorrhage is often due to compression by a posterior communicating artery aneurysm. Anterior communicating artery (ACOM) aneurysms may produce ophthalmologic symptoms of the anterior visual pathways, but rarely ever lead to a 3rd nerve palsy. T...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-007-0054-4
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:The correlation between noninvasive (oscillometric) blood pressure (NBP) and intra-arterial blood pressure (IAP) in critically ill patients receiving vasoactive medications in a Neurocritical Care Unit has not been systematically studied. The purpose of this study is to examine the relationship between simul...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-018-0521-0
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:In patients with spontaneous intracerebral hemorrhage (ICH), pre-hospital markers of disease severity might be useful to potentially triage patients to undergo early interventions. OBJECTIVE:Here, we tested whether loss of consciousness (LOC) at the onset of ICH is associated with intraventricular hemorrhag...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-020-01180-2
更新日期:2021-01-21 00:00:00
abstract:BACKGROUND/OBJECTIVE:Infection is the most common complication of external ventricular drain (EVD) placement. National trends in the annual incidence of meningitis among patients with traumatic brain injury (TBI) who have undergone EVD placement have not been reported. METHODS:The Nationwide Inpatient Sample was used ...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-018-0656-z
更新日期:2019-06-01 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:BACKGROUND:Clinical recognition of acute bacterial meningitis (ABM) and its early prognostication would guide the degree of intensive treatment required. We aimed to study the clinical features and factors associated with death in patients with community acquired ABM. METHODS:Adult patients with clinically suspected c...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-010-9396-4
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:Infection in the intensive care unit (ICU) empirically requires broad-spectrum antibiotics. Imipenem/cilastatin, often reserved for more serious hospital-acquired infections, is thought to be associated with a higher risk of seizures than other penicillins and carbapenems. We sought to evaluate the safety of...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-008-9170-z
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Abusive head trauma (AHT) is a common condition in children. Little is known in this condition regarding the frequency of seizures, the factors associated with increased risk of seizures, or the association of seizures with outcome. We sought to determine frequency and risks for in-hospital seizures after AH...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-010-9468-5
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND:Little data exist regarding the practice of sodium management in acute neurologically injured patients. This study describes the practice variations, thresholds for treatment, and effectiveness of treatment in this population. METHODS:This retrospective, multicenter, observational study identified 400 ICU p...
journal_title:Neurocritical care
pub_type: 杂志文章,多中心研究
doi:10.1007/s12028-016-0343-x
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:Seizures are a common complication after intracerebral hemorrhage (ICH) but there is a substantial lack of information on the long-term incidence in ICH survivors and whether post-ICH seizures affect functional long-term outcome. METHODS:Over a five-year period 464 consecutive patients with spontaneous ICH ...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-014-9968-9
更新日期:2014-10-01 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:INTRODUCTION:Effective treatment for severe ischemic stroke continues to be largely an unmet medical need. Using a nonvascular (paravascular cerebrospinal fluid) pathway to provide oxygen and nutrients to ischemic tissues may be a means of treating this disease. The primary objective of this study was to evaluate the s...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1385/NCC:5:1:21
更新日期:2006-01-01 00:00:00
abstract:INTRODUCTION:Delayed posthypoxic demyelination may rarely complicate an episode of severe hypoxia, with or without exposure to carbon monoxide. Following recovery from initial coma, progressive neurologic deterioration ensues with outcomes ranging from death to full recovery. Delayed posthypoxic demyelination is hypoth...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-007-0044-6
更新日期:2007-01-01 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