Abstract:
BACKGROUND:Delayed ischemic neurological deficits (DINDs) contribute to morbidity and mortality following aneurysmal subarachnoid hemorrhage (SAH). Based on promising preliminary reports, some clinicians routinely administer statins to prevent DINDs. METHODS:Without language restriction, we searched MEDLINE, EMBASE, the Cochrane Central Register, references of review articles, proceedings of the International Stroke Conference, and gray literature sources. Studies were selected if they compared outcomes between statin-treated and untreated patients during the 2 weeks following SAH. Data were extracted and appraised independently and in duplicate, using standardized forms. Fixed or random effects models, as appropriate based on the degree of study heterogeneity, were applied to calculate summary measures. RESULTS:Four RCTs, two "pseudo" RCTs, five cohort studies, and one case-control study met eligibility criteria. In the RCTs, which enrolled a total of 309 patients, statins were found to significantly reduce the occurrence of DINDs [OR 0.38 (0.23-0.65); P < 0.001], but not mortality [OR 0.51 (0.25-1.02); P = 0.06] or poor neurological recovery [OR 0.81 (0.49-1.32); P = 0.39]. Observational studies assessed 1,542 patients, of whom 385 received statins. Statin-use was not associated with any reduction in DINDs [OR 0.96 (0.71-1.31); P = 0.80], mortality [OR 1.16 (0.78-1.73); P = 0.47] or poor neurological recovery [OR 1.20 (0.84-1.72); P = 0.31]. When the results of all studies were combined, statins had no statistically significant effect. CONCLUSIONS:Existing RCTs suggest that statins reduce DINDs, with a possible trend toward lower mortality. These findings are not supported by observational research. Although not assessed in all studies, current data do not indicate that statins improve neurological outcomes.
journal_name
Neurocrit Carejournal_title
Neurocritical careauthors
Kramer AH,Fletcher JJdoi
10.1007/s12028-009-9306-9subject
Has Abstractpub_date
2010-04-01 00:00:00pages
285-96issue
2eissn
1541-6933issn
1556-0961journal_volume
12pub_type
杂志文章,meta分析,评审abstract:BACKGROUND:Highly asymmetric clinical signs in a patient suggest the need for caution in making the diagnosis of Guillain-Barré Syndrome (GBS). METHODS:Case report and literature review. We present a case of strictly unilateral left third cranial nerve palsy in a patient with GBS, review other highly asymmetrical cran...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1385/NCC:1:4:461
更新日期:2004-01-01 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:BACKGROUND:Noncontrast computed tomography (CT) markers are increasingly used for predicting hematoma expansion. The aim of our study was to investigate the predictive value of expansion-prone hematoma in predicting hematoma expansion and outcome in patients with intracerebral hemorrhage (ICH). METHODS:Between July 20...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-018-0644-3
更新日期:2019-06-01 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: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:BACKGROUND:The effects of induced hypertension (IH) on cerebral perfusion after subarachnoid hemorrhage (SAH) are unclear. The objectives of this investigation are to: (1) determine whether there are differences in cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) measured with compute...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-017-0379-6
更新日期:2017-08-01 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: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:BACKGROUND/OBJECTIVE:Posterior reversible encephalopathy syndrome (PRES) is a clinical and radiologic entity, typically manifesting as reversible neurological symptoms and signs of white matter edema on magnetic resonance imaging. PRES has been widely described in adults. Studies of PRES in children are mostly limited ...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-019-00720-9
更新日期:2020-02-01 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:The pathogenesis of delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (SAH) remains obscure. The authors assessed the relationship of tumor necrosis factor alpha (TNF-α) and TNF-α gene polymorphisms with occurrence of DCI and poor outcome at 3 months. METHODS:Serum levels of TNF-α were measure...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-011-9556-1
更新日期:2011-12-01 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:BACKGROUND:There is some evidence that hyperglycemia increases the rate of poor outcomes in patients with intracerebral hemorrhage (ICH). We explored the relationship between various parameters of serum glucose concentrations measured during acute hospitalization and hematoma expansion, perihematomal edema, and three m...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-011-9541-8
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:Neurocardiogenic injury results from increased sympathetic nervous system activation following acute brain injury. No diagnostic criteria for neurocardiogenic injury exist, and agreement has not been tested. We investigated the agreement by neurointensivists for the presence of neurocardiogenic injury on rou...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-013-9941-z
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:Stroke is common after aneurysmal subarachnoid hemorrhage (aSAH). Transcranial Doppler ultrasound (TCD) monitoring is often employed to identify vasospasm and allow intervention to avoid infarction. The required duration of monitoring has not been established. We aim to determine if 10 days of TCD monitoring...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-011-9564-1
更新日期:2011-12-01 00:00:00
abstract::Drowning is a leading cause of accidental death. Survivors may sustain severe neurologic morbidity. There is negligible research specific to brain injury in drowning making current clinical management non-specific to this disorder. This review represents an evidence-based consensus effort to provide recommendations fo...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-012-9747-4
更新日期:2012-12-01 00:00:00
abstract:INTRODUCTION:To describe a new device meant for rapid endovascular thrombectomy of intracranial arteries of various sizes and its first clinical use. METHODS:A device with oriented microfilaments was constructed that consists of a core wires compound surrounded by a dense palisade of perpendicular-oriented stiff polya...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1385/NCC:5:2:134
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:Attitudes toward the degree of acceptable disability and the importance of aphasia are critical in deciding on decompressive hemicraniectomy (DHC) in space-occupying middle cerebral artery stroke (SOS). The attitudes of nurses deserve strong attention, because of their close interaction with patients during ...
journal_title:Neurocritical care
pub_type: 杂志文章,多中心研究
doi:10.1007/s12028-018-0586-9
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:Status, refractory status and super refractory status epilepticus are common neurologic emergencies. The objective of this study is to investigate the feasibility, safety and effectiveness of a ketogenic diet (KD) for refractory status epilepticus (RSE) in adults in the intensive care unit (ICU). METHODS:We...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-018-0653-2
更新日期:2019-06-01 00:00:00
abstract:OBJECTIVE:To determine the clinical characteristics and outcomes of patients with neurogenic stress cardiomyopathy (NSC) among patients admitted to our neuroscience intensive care unit (NICU). METHODS:Following institutional review board approval, consecutive adult patients admitted to the NICU between 2009 and 2013 w...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-017-0412-9
更新日期:2017-12-01 00:00:00
abstract:INTRODUCTION:Status epilepticus remains a life-threatening condition that afflicts both adults and children which although occurs in patients with epilepsy, often presents as new-onset seizure activity also. Refractory status epilepticus poses a management challenge for neurological and neurosurgical teams. CASE REPOR...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-007-0038-4
更新日期:2007-01-01 00:00:00
abstract:INTRODUCTION:Syringohydromyelia associated with supratentorial space-occupying lesion has rarely been reported. We present a 28-year-old woman was admitted to the hospital with head and neck pain. Upon examination, there was only left central facial paralisia, with no evidence of papilledema. METHODS AND RESULTS:Crani...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1385/NCC:2:1:051
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:Cerebral blood flow (CBF) measurements are helpful in managing patients with traumatic brain injury (TBI), and testing the cerebrovascular reactivity to CO(2) provides information about injury severity and outcome. The complexity and potential hazard of performing CBF measurements limits routine clinical use...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-012-9727-8
更新日期:2014-02-01 00:00:00
abstract::Recombinant activated factor VII (rFVIIa, NovoSeven, NovoNordisc, Danemark) has been approved for the treatment of patients with hemophilia with inhibitors, further indications, at least in some countries, include the treatment of factor VII deficiency and Glanzmann thrombasthenia refractory to conventional therapy. A...
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:OBJECTIVE:Stroke due to occlusion of the artery of Percheron (AOP), an uncommon anatomic variant supplying the bilateral medial thalami, may raise diagnostic challenges and cause life-threatening symptoms. Our objective here was to detail the features and outcomes in three patients who required intensive care unit (ICU...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-014-9962-2
更新日期:2014-06-01 00:00:00
abstract::Neurocritical care relies on the continuous, real-time measurement of numerous physiologic parameters. While our capability to obtain such measurements from patients has grown markedly with multimodal monitoring in many neurologic or neurosurgical intensive care units (ICUs), our ability to transform the raw data into...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-013-9872-8
更新日期:2014-02-01 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:OBJECTIVE:To summarize trends in status epilepticus (SE) in the United States by age, race, sex, admission source, disposition, incidence rates, and mortality. METHODS:Data from US National Hospital Discharge Survey were used from 1979 to 2010 to identify discharges with SE and common etiologies and complications of S...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-013-9935-x
更新日期:2014-06-01 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