Abstract:
BACKGROUND:Impaired cerebrovascular reactivity (CR) has been reported to be associated with adverse outcome in patients with aneurysmal subarachnoid hemorrhage (aSAH). However, CR may be determined using different paradigms and it is unclear, which measurement method most suitable reflects the clinical course or is able to predict clinical deterioration. METHODS:Twenty-one aSAH patients were included in this study. Following occlusion of the aneurysms with or without implantation of nicardipine prolonged release implants (NPRIs), mean arterial and mean intracranial pressure, regional tissue oxygenation, and regional cerebral blood flow was determined. Based on these data, pressure-, oxygen-, and flow-related autoregulatory indices (PRx, ORx, FRx) were simultaneously calculated and correlated with outcome parameters including the Glasgow outcome score (GOS) and the modified Rankin (mRankin) scale. RESULTS:Eight patients showed newly developed cerebral infarcts. Low values of GOS and mRankin scale highly correlated with the incidence of cerebral infarcts (GOS, P = 0.001; mRankin, P = 0.003). However, indices of CR did not differ significantly between the infarction (I) and the noninfarction group (NI) (PRx, I, 0.058 +/- 0.096, NI, 0.097 +/- 0.203, P = 0.538; ORx, I, 0.162 +/- 0.316, NI, 0.094 +/- 0.176, P = 0.690; FRx, I, 0.395 +/- 0.200, NI, 0.265 +/- 0.177, P = 0.119). No correlation was found between indices and clinical outcome parameters (all not significant). However, ORx and FRx correlated well (P = 0.016). CONCLUSIONS:Due to the low number of included subjects, the obtained results are preliminary. However, they indicate that either the present technique of index-determination is not sensitive enough or that there is no strong relation between the measured indices and clinical outcome. Future verification is required of continuous against already established non-continuous monitoring techniques of CR in order to relate both to clinical outcome.
journal_name
Neurocrit Carejournal_title
Neurocritical careauthors
Barth M,Woitzik J,Weiss C,Muench E,Diepers M,Schmiedek P,Kasuya H,Vajkoczy Pdoi
10.1007/s12028-009-9287-8subject
Has Abstractpub_date
2010-04-01 00:00:00pages
234-43issue
2eissn
1541-6933issn
1556-0961journal_volume
12pub_type
杂志文章,评审abstract:BACKGROUND:Subarachnoid hemorrhage (SAH) is a devastating disease. Nimodipine is the only medical treatment shown to improve outcome of SAH patients. Human albumin (ALB) may exert neuroprotection in SAH. However, current usage of ALB in SAH is not known. We conducted an international survey of clinicians involved in th...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-013-9942-y
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:It is controversial whether a low cerebral blood flow (CBF) simply reflects the severity of injury or whether ischemia contributes to the brain's injury. It is also not clear whether posttraumatic cerebral hypoperfusion results from intracranial hypertension or from pathologic changes of the cerebral vascula...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1385/NCC:1:1:69
更新日期:2004-01-01 00:00:00
abstract:INTRODUCTION:It is unclear whether the rate of stimulation for somatosensory evoked potentials (SEPs) can influence the presence or absence of cortical responses to median nerve stimulation in comatose patients. If so, this could affect how SEPs are performed and interpreted for prognostication in coma. Our objective w...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-009-9191-2
更新日期:2010-02-01 00:00:00
abstract:BACKGROUND:Angiographic vasculitis affecting the spine has been rarely described. The use of immunosuppression as a primary treatment and a review of the literature is presented. METHODS:Case report. RESULTS:A 61-year-old female presented with sudden onset back pain and headache. The patient was found to have acute s...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-011-9667-8
更新日期:2012-04-01 00:00:00
abstract::Electroencephalography in the setting of hypothermia and anoxia has been studied in humans since the 1950s. Specific patterns after cardiac arrest have been associated with prognosis since the 1960s, with several prognostic rating scales developed in the second half of the twentieth century. In 2002, two pivotal clini...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-014-0018-4
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:Spontaneous intracranial hypotension (SIH) is a neurologic condition with the prototypical symptom of orthostatic headache. We report a dramatic case of SIH with life-threatening bilateral hygroma and uncal herniation. METHODS:Case report. RESULTS:A 44-year-old male patient presenting with orthostatic head...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-012-9783-0
更新日期:2013-08-01 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:Hyponatremia may complicate brain injury and exacerbate cerebral edema and intracranial pressure (ICP). Vasopressin-receptor antagonists (such as conivaptan) are promising novel agents to treat hyponatremia that act by inducing aquaresis. It is unclear whether raising serum sodium in this way could also conf...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-010-9366-x
更新日期:2011-02-01 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:Subclinical seizures are common in critically ill children and are best detected by continuous EEG (cEEG) monitoring. Timely detection of seizures requires pediatric intensive care unit (PICU) physicians to identify patients at risk of seizures and request cEEG monitoring. A recent consensus statement from t...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-020-01053-8
更新日期:2020-07-21 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: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:Direct invasive monitoring of brain tissue oxygenation (PbtO(2)) has been routinely utilized to predict cerebral ischemia and to prevent secondary injury in patients with traumatic brain injury (TBI) and vasospasm secondary to subarachnoid hemorrhage (SAH). The safety and utility of these devices in the pedi...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-011-9531-x
更新日期:2011-12-01 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:BACKGROUND:Fever in neurocritical care patients is common and has a negative impact on neurological outcome. The purpose of this prospective observational study was (1) to evaluate the practicability of cooling with newly developed neck pads in the daily setting of neurointensive care unit (NICU) patients and (2) to ev...
journal_title:Neurocritical care
pub_type: 临床试验,杂志文章
doi:10.1007/s12028-010-9451-1
更新日期:2011-08-01 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:The management of symptomatic cerebral vasospasm after aneurysmal subarachnoid hemorrhage (aSAH) can be often complicated by the presence of stunned myocardium and left ventricular failure. Vasopressors and inotropes are commonly used to optimize mean arterial pressure (MAP) and cerebral perfusion pressure (...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-010-9358-x
更新日期:2010-08-01 00:00:00
abstract::The presence of pulmonary dysfunction after brain injury is well recognized. Acute lung injury (ALI) occurs in 20% of patients with isolated brain injury and is associated with a poor outcome. The "blast injury" theory, which proposes combined "hydrostatic" and "high permeability" mechanisms for the formation of neuro...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-009-9242-8
更新日期:2009-12-01 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: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:Fever is common and difficult to control in patients with subarachnoid hemorrhage (SAH). We have previously shown an inverse relationship between fever and outcome in patients with SAH. MATERIALS/METHODS:This was a prospective, single-arm, feasibility trial in which nine patients with SAH underwent temper...
journal_title:Neurocritical care
pub_type: 临床试验,杂志文章
doi:10.1385/NCC:1:2:145
更新日期:2004-01-01 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:No proven treatments exist for intracerebral hemorrhage (ICH). Carefully selected patients may benefit from surgery, and an international multicenter trial is ongoing. We sought to determine how many patients in a population-based ICH cohort would have been eligible for surgery using the Surgical Trial in ...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-007-9045-8
更新日期:2008-01-01 00:00:00
abstract::Immobility that is frequently encountered in the intensive care unit (ICU) can lead to patient complications. Early mobilization of patients in the ICU has been shown to reduce the complications associated with critical illness; however, early mobilization in the neurological intensive care unit (NICU) presents a uniq...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-016-0338-7
更新日期:2017-08-01 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: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:Neurogenic pulmonary edema (NPE) is an acute life-threatening complication associated with many forms of central nervous system injury. NPE usually appears within minutes to hours after injury and has a high mortality rate if not recognized and treated appropriately. Lung ultrasound quickly provides at the b...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-013-9828-z
更新日期:2013-06-01 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: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: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