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 the accuracy of the CT angiography (CTA) spot sign for identifying risk of hematoma expansion. METHODS:We analyzed 391 consecutive patients undergoing CTA and a followup CT. CTA spot sign readings were performed by two experienced readers and hematoma expansion was assessed by means of semi-automated software. RESULTS:Hematoma expansion occurred in 18 % of patients. When stratified by time from symptom onset to initial CT, hematoma expansion rates were: 39 % within 3 h; 11 % between 3 and 6 h, 11 % beyond 6 h (but with known onset), and 20 % in patients with unknown symptom onset. Of patients who developed hematoma expansion, only 38 % presented within 3 h. The accuracy of the spot sign in predicting hematoma expansion was 0.67 for patients presenting within 3 h, 0.83 between 3 and 6 h, 0.88 after 6 h, and 0.76 for patients presenting with an unknown onset time. CONCLUSIONS:A substantial number of patients destined to suffer from hematoma expansion present either late or with an unknown symptom onset time. The CTA spot sign accurately identifies patients destined to expand regardless of time from symptom onset, and may therefore open a path to offer clinical trials and novel therapies to the many patients who do not present acutely.
journal_name
Neurocrit Carejournal_title
Neurocritical careauthors
Brouwers HB,Falcone GJ,McNamara KA,Ayres AM,Oleinik A,Schwab K,Romero JM,Viswanathan A,Greenberg SM,Rosand J,Goldstein JNdoi
10.1007/s12028-012-9765-2subject
Has Abstractpub_date
2012-12-01 00:00:00pages
421-8issue
3eissn
1541-6933issn
1556-0961journal_volume
17pub_type
杂志文章abstract：INTRODUCTION:Hydrocephalus with normal intracranial pressure has rarely been reported to result in herniation. METHODS:Case report. RESULTS:A 52-year-old man became acutely comatose with extensor posturing and ventriculomegaly 17 days after experiencing a primary ventricular hemorrhage. An external ventricular drain ...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1385/NCC:2:2:172
更新日期：2005-01-01 00:00:00
abstract：BACKGROUND:This study compares the effect of mild and severe cerebral ischemia on neuronal damage and neurogenesis. METHODS:Sixteen Sprague-Dawley rats, anesthetized with 0.8 vol% halothane in O(2)/air, were subjected to forebrain ischemia by bilateral common carotid artery occlusion plus hemorrhagic hypotension (mean...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-008-9121-8
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: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: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: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：INTRODUCTION:Despite the recognized deleterious effects of hyperthermia on critically ill neurological patients, few investigations have studied hyperthermia after an ischemic stroke in the intensive care unit (ICU) setting. METHODS:Acute ischemic stroke patients admitted to the ICU were assigned to one of three group...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-008-9056-0
更新日期：2008-01-01 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：: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
abstract：BACKGROUND:Takotsubo syndrome is a reversible neuromyocardial failure that has been thought to be related to an acute catecholamine toxicity of the myocardium brought upon by a stressful event. The neurocritical care unit population is particularly vulnerable for this condition given the acute presentation of neurologi...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-008-9075-x
更新日期：2008-01-01 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: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：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：:Computed tomography (CT) scan of the brain transitioned clinical neurology from the educated-guess world to the real computer-age world. One of the first CT scans-published by the British neuroradiologist James Ambrose-showed an intracranial hemorrhage and also suggested the use of iodine to demonstrate abnormal blood...
journal_title：Neurocritical care
pub_type： 历史文章,杂志文章
doi：10.1007/s12028-017-0495-3
更新日期：2018-06-01 00:00:00
abstract：BACKGROUND:The objective was to investigate the impact of targeting tight glycemic control (4.4-6.1 mM) on endogenous ketogenesis in severely head-injured adults. METHODS:The data were prospectively collected during a randomized, within-patient crossover study comparing tight to loose glycemic control, defined as 6.7-...
journal_title：Neurocritical care
pub_type： 杂志文章,随机对照试验
doi：10.1007/s12028-016-0313-3
更新日期：2017-04-01 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：BACKGROUND:There are some intracranial insults which are associated with cardiac abnormalities. Studies of these abnormalities have never been carried out in elective intracranial neurosurgery for the removal of brain tumors. Our prospective study aims at quantifying serum cardiac troponin T (cTnT) and N-terminal pro-b...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-012-9684-2
更新日期：2012-12-01 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: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: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：BACKGROUND:Cerebral vasospasm is the main cause of neurological mortality and morbidity following subarachnoid hemorrhage. Basilar artery vasospasm (BAVS) is associated with a high morbidity and may have multiple clinical presentations. METHODS:We report the case of a 43 years-old man with BAVS presenting as a reversi...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-011-9655-z
更新日期：2012-02-01 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：: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：INTRODUCTION:Liver transplant (LT) recipients are at significant risk for the development of neurological complications, such as altered mental status and seizures, in the postoperative period. Identifying accurate predictors of these events may allow optimal selection and preparation of candidates, and minimize risk a...
journal_title：Neurocritical care
pub_type： 杂志文章
doi：10.1007/s12028-007-9020-4
更新日期：2008-01-01 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: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：BACKGROUND:Global cerebral edema (GCE) is a manifestation of early brain injury (EBI) after subarachnoid hemorrhage (SAH) and is an independent risk factor for poor outcome. The lack of a quantitative method to measure GCE limits the study of its pathophysiology. The goal of this study is to develop a quantitative surr...
journal_title：Neurocritical care
pub_type： 临床试验,杂志文章
doi：10.1007/s12028-015-0229-3
更新日期：2016-08-01 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：:Neuromuscular disorders increasingly are recognized as a complication in patients in the intensive care unit (ICU) and represent a common cause of prolonged ventilator dependency. The distinct syndromes of critical illness myopathy, prolonged neuromuscular blockade, and critical illness polyneuropathy (CIP) may arise ...
journal_title：Neurocritical care
pub_type： 杂志文章,评审
doi：10.1385/NCC:3:3:195
更新日期：2005-01-01 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
