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 neurotoxic effects in some patients remains uncertain. METHODS/RESULTS: CASE REPORT:A 67-year-old male underwent lumbar laminectomy followed by parathyroidectomy. Postoperatively, he was comatose (Glasgow Coma Scale of 7) and underwent extensive neurological evaluation. Brain computed tomography (CT) imaging and CT angiography revealed no ischemia, vessel occlusion, or hemorrhage. Electroencephalogram (EEG) showed only slowing of cerebral hemispheric activity bilaterally. Over the next 48 h, his mental status slowly improved and the patient made a full neurological recovery (Glasgow Coma Scale 15). CONCLUSION:Methylene blue, when used in patients on antidepressant drugs, may be associated with a transient encephalopathic state and serotonin syndrome. Patients on antidepressants undergoing parathyroidectomy who may receive MB infusion should be considered for alternative parathyroid gland identification or discontinuation of the antidepressants before surgery. MB-associated serotonin syndrome is an increasing and under recognized ('green') post-operative encephalopathy that warrants education to critical care neurologists and other physicians.
journal_name
Neurocrit Carejournal_title
Neurocritical careauthors
Rowley M,Riutort K,Shapiro D,Casler J,Festic E,Freeman WDdoi
10.1007/s12028-009-9206-zsubject
Has Abstractpub_date
2009-01-01 00:00:00pages
88-93issue
1eissn
1541-6933issn
1556-0961journal_volume
11pub_type
杂志文章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::We now recognize that the main breathing generator resides principally in the medulla oblongata. Vivisectionists-specifically, Julien Legallois-discovered "the respiratory center." Cutting through the brainstem stops respiration but not if the medulla remains intact and the brain is sliced in successive portions. Pier...
journal_title:Neurocritical care
pub_type: 历史文章,杂志文章
doi:10.1007/s12028-019-00686-8
更新日期:2019-08-01 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:BACKGROUND:Case reports suggest lacosamide may have a role in status epilepticus (SE). The purpose of this case series is to describe the use of lacosamide in refractory SE (RSE) at our institution. METHODS:Observational study of all patients admitted to the neurosciences intensive care unit with RSE who received at l...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-010-9501-8
更新日期:2011-06-01 00:00:00
abstract:BACKGROUND:Improvements in technology play an important role in caring for critically ill patients. One example is the advance in ventilator design to facilitate triggering of mechanical breaths. Minimal changes in circuit flow unrelated to respiratory effort can trigger a ventilator breath and may mislead caregivers i...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-010-9491-6
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND:This prospective study of an innovative non-invasive ultrasonic cerebrovascular autoregulation (CA) monitoring method is based on real-time measurements of intracranial blood volume (IBV) reactions following changes in arterial blood pressure. In this study, we aimed to determine the clinical applicability o...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-018-0569-x
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:Oral anticoagulants have been associated with greater hematoma expansion in patients with intracerebral hemorrhage (ICH). The purpose of this study was to determine whether the reported use of antiplatelet agents also results in greater hematoma expansion. METHODS:Retrospective review of patients with spont...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-009-9290-0
更新日期:2010-02-01 00:00:00
abstract::A farmer's wife was slapped by her cow's tail during milking. There was no obvious injury, but afterward she first developed unusual headaches of unknown origin and then a severe stroke 7 days later. Further diagnostics, including magnetic resonance imaging techniques, revealed a dissection of the carotid artery to be...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1385/NCC:3:3:254
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:Apnea testing is an essential step in the clinical diagnosis of brain death. Current international guidelines recommend placement of an oxygen (O2) insufflation catheter into the endotracheal tube to prevent hypoxemia, but use of a continuous positive airway pressure (CPAP) valve may be more effective at lim...
journal_title:Neurocritical care
pub_type: 杂志文章,多中心研究
doi:10.1007/s12028-017-0380-0
更新日期:2017-08-01 00:00:00
abstract::The Fifth Neurocritical Care Research Network (NCRN) Conference held in Boca Raton, Florida, in September of 2018 was devoted to challenging the current status quo and examining the role of the Neurocritical Care Society (NCS) in driving the science and research of neurocritical care. The aim of this in-person meeting...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-019-00767-8
更新日期:2020-02-01 00:00:00
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journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-007-0006-z
更新日期:2007-01-01 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:BACKGROUND:Infection is common following stroke and is independently associated with worse outcome. Clinical studies suggest that infections occur more frequently in those individuals with stroke-induced immunologic dysfunction. This study sought to explore the contribution of immunomodulatory cytokines and hormones to...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-010-9490-7
更新日期:2011-04-01 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:Pneumocephalus is commonly encountered after neurosurgical procedures but can also be caused by craniofacial trauma and tumors of the skull base and rarely, can occur spontaneously. Contributing factors for the development of pneumocephalus include head position, duration of surgery, nitrous oxide (N(2)O) an...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-010-9363-0
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND:Median nerve short-latency somatosensory evoked potentials (SSEPs) are useful in determining prognosis for awakening after coma following hypoxic ischemic encephalopathy, but reliability of interpretation is unclear. OBJECTIVE:To measure inter- and intra-observer reliability of determining presence or absen...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-009-9251-7
更新日期:2009-12-01 00:00:00
abstract::This article reports an unusual case of a syphilitic gumma with a clinical and radiographical presentation initially suggestive of glioblastoma multiforme. Pathological evaluation was essential in establishing the diagnosis of neurosyphilis and in excluding neoplastic involvement. Cerebral gumma should be considered a...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1385/NCC:2:3:300
更新日期:2005-01-01 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:INTRODUCTION:The treatment and outcomes of heparin-induced thrombocytopenia (HIT) are not well described in neurosurgery patients. This study reviewed the treatment for HIT in subarachnoid hemorrhage (SAH) patients, and compared outcomes in patients with isolated HIT (iHIT) and HIT with thrombotic syndrome (HITTS). ME...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-012-9725-x
更新日期:2012-10-01 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 AND OBJECTIVE:An increasing number of patients receive antiplatelet therapy. Patients exposed to surgery while receiving platelet inhibitors hold an increased bleeding risk. Especially in neurosurgery and neurocritical care patients, bleeding and hematoma expansion are feared complications as even minor blee...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-020-01055-6
更新日期:2020-08-04 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:INTRODUCTION:Malignant cerebral edema develops in a small subset of patients with hemispheric strokes, precipitating deterioration and death if decompressive hemicraniectomy (DHC) is not performed in a timely manner. Predicting which stroke patients will develop malignant edema is imprecise based on clinical data alone...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-020-01056-5
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Plateau waves are common in traumatic brain injury. They constitute abrupt increases of intracranial pressure (ICP) above 40 mmHg associated with a decrease in cerebral perfusion pressure (CPP). The aim of this study was to describe plateau waves characteristics with multimodal brain monitoring in head injur...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-013-9918-y
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:Sedation and therapeutic hypothermia (TH) delay neurological responses and might reduce the accuracy of clinical examination to predict outcome after cardiac arrest (CA). We examined the accuracy of quantitative pupillary light reactivity (PLR), using an automated infrared pupillometry, to predict outcome of...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-014-9981-z
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:Brain tissue hypoxia (PbtO2 < 20 mmHg) is common after subarachnoid hemorrhage (SAH) and associated with poor outcome. Recent data suggest that brain oxygen optimization is feasible and reduces the time spent with PbtO2 < 20 mmHg from 45 to 16% in patients with severe traumatic brain injury. Here, we intende...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-019-00753-0
更新日期:2019-10-01 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::Acute ischemic stroke is a neurological emergency that can be treated with time-sensitive interventions, including both intravenous thrombolysis and endovascular approaches to thrombus removal. Extensive study has demonstrated that rapid, protocolized, assessment and treatment is essential to improving neurological ou...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-017-0449-9
更新日期:2017-09-01 00:00:00
abstract:BACKGROUND:The natural history of cerebral aneurysms derived from metastatic spread of cardiac myxomas is not well known, and their management presents many dilemmas. METHODS:Case report and literature review. RESULTS:An 18-year-old man presented with an intraparenchymal hemorrhage several months after resection of a...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-010-9400-z
更新日期:2010-10-01 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