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 pediatric population have been examined in a few small studies. No studies, however, have examined the use of PbtO(2) monitoring in stroke patients. METHODS:Retrospective chart review of the first two consecutive, critically ill pediatric patients in the pediatric intensive care unit requiring brain tissue oxygen monitoring for newly diagnosed cerebral ischemia. ICP, CPP, PbtO(2), SaO(2), BP, and RR were all continually monitored during their care and were retrospectively collected and reviewed. RESULTS:We present two pediatric stroke patients managed in a critical care setting with PbtO(2) monitoring in addition to ICP, MAP, CPP, and SaO(2). Both patients had multiple events of low brain tissue oxygen (PbtO(2) <20 torr), independent of abnormal values in other monitoring parameters, which required physician intervention. No new ischemic damage occurred after PbtO(2) monitoring began in either patient. CONCLUSIONS:There is currently inadequate data to support the application of PbtO(2) monitoring in children with stroke to prevent progressive ischemia and to improve outcome. However, the positive results for these two patients support the need for further study in this area.
journal_name
Neurocrit Carejournal_title
Neurocritical careauthors
Allen BB,Hoffman CE,Traube CS,Weinstein SL,Greenfield JPdoi
10.1007/s12028-011-9531-xsubject
Has Abstractpub_date
2011-12-01 00:00:00pages
529-36issue
3eissn
1541-6933issn
1556-0961journal_volume
15pub_type
杂志文章abstract:BACKGROUND:A pretruncal subarachnoid hemorrhage has been accepted as a "benign" entity. Here we present two patients with delayed cerebral infarction following pretruncal subarachnoid hemorrhage. METHODS:Case report. RESULTS:Two patients with possible delayed cerebral infarction after pretruncal subarachnoid hemorrha...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-010-9403-9
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND/OBJECTIVE:In recent years, the noble gas argon (Ar) has been extensively studied for its organ protection properties. While mounting in vitro and in vivo evidence indicates that argon provides neuroprotection in ischemic brain injury, its neuroprotective potential in traumatic brain injury (TBI) has not been...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-020-01104-0
更新日期:2020-09-21 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:BACKGROUND:Several methods have been proposed to measure cerebrovascular autoregulation (CA) in traumatic brain injury (TBI), but the lack of a gold standard and the absence of prospective clinical data on risks, impact on care and outcomes of implementation of CA-guided management lead to uncertainty. AIM:To formulat...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-020-01185-x
更新日期:2021-01-25 00:00:00
abstract:BACKGROUND:In the postpartum patient, sudden depression of consciousness may be caused by a number of etiologies and can result in serious consequences. Rapid, accurate diagnosis allows for specific treatments that optimize outcome, but diagnosis can be challenging in this population. We present a case of postpartum he...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-012-9742-9
更新日期:2012-12-01 00:00:00
abstract:INTRODUCTION:The importance of preoperative response to external ventricular drainage (EVD) for treatment of acute hydrocephalus (HCP) following poor grade (Hunt & Hess grade IV or V) aneurysmal subarachnoid hemorrhage (aSAH) has not been clearly defined. The effect of EVD response on preoperative grade and prognosis i...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-007-0019-7
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:Early recognition and treatment of autoimmune encephalitis (AE) has become an essential issue in clinical practice. However, little is known about patients with deteriorating conditions and the need for intensive care treatment. Here, we aimed to characterize underlying aetiologies, clinical symptoms, reason...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-016-0370-7
更新日期:2017-08-01 00:00:00
abstract:INTRODUCTION:Point-of-care ultrasound of the optic nerve sheath diameter (ONSD) to diagnose increased intracranial pressure (ICP) is of great interest in various clinical scenarios. Yet, the lack of examination standardization has made clinical utility difficult. We compare three ultrasound ocular plane views (inferior...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-019-00881-7
更新日期:2020-08-01 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: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::Maintenance of adequate oxygenation is a mainstay of intensive care, however, recommendations on the safety, accuracy, and the potential clinical utility of invasive and non-invasive tools to monitor brain and systemic oxygenation in neurocritical care are lacking. A literature search was conducted for English languag...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-014-0024-6
更新日期:2014-12-01 00:00:00
abstract:: ...
journal_title:Neurocritical care
pub_type: 评论,信件
doi:10.1007/s12028-018-0664-z
更新日期:2019-04-01 00:00:00
abstract:INTRODUCTION:Hyponatremia frequently complicates acute brain injury and may precipitate neurological worsening by promoting cerebral edema. An increase in brain water may be better managed through water excretion than with fluid restriction or hypertonic fluids. Vasopressin-receptor antagonists such as conivaptan, whic...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-008-9179-3
更新日期:2009-01-01 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:Patients on neurological intensive care units (NICU) who require ventilatory support often suffer from co-existing bulbar dysfunction, either because of their underlying disease or because of their decreased level of consciousness. For this reason, most patients are ventilated through a cuffed tracheostomy...
journal_title:Neurocritical care
pub_type: 临床试验,杂志文章
doi:10.1007/s12028-007-0024-x
更新日期:2007-01-01 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: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:BACKGROUND:Intra-arterial (IA) nicardipine is often used to treat cerebral vasospasm associated with subarachnoid hemorrhage (SAH). While hypotension has been noted to be a dose-limiting side effect of intravenous infusions, this has seldom been reported for IA administration. METHODS:We reviewed a consecutive series ...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-011-9537-4
更新日期:2011-12-01 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: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:Therapeutic hypothermia (i.e., temperature management) is an effective option for improving survival and neurological outcome after cardiac arrest and is potentially useful for the care of the critically ill neurological patient. We analyzed the feasibility of a device to control the temperature of the brain...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-016-0257-7
更新日期:2016-12-01 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:To describe a case of auto-immune encephalitis in an adolescent with favorable outcome despite prolonged status epilepticus. METHODS:A 17 year old Asian man without previous medical history developed alteration of consciousness and partial seizures. The diagnosis of anti-N-methyl-D-aspartate receptor enceph...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-012-9788-8
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND:Diagnosis of intensive care unit acquired weakness (ICUAW) is challenging. Pathogenesis of underlying critical illness polyneuromyopathy (CIPNM) remains incompletely understood. This exploratory study investigated whether longitudinal neuromuscular ultrasound examinations and cytokine analyses in correlation...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-020-01148-2
更新日期:2020-11-24 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::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 time...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1385/NCC:5:3:206
更新日期:2006-01-01 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: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:INTRODUCTION:Dynamic testing of cerebral pressure autoregulation is more practical than static testing for critically ill patients. The process of cuff deflation is innocuous in the normal subject, but the systemic and cerebral effects of cuff deflation in severely head-injured patients have not been studied. The purpo...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1385/NCC:4:2:127
更新日期:2006-01-01 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