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, reasons for intensive care admission, and mortality of critically ill patients with AE. METHODS:We conducted a retrospective chart review of all patients with "definite" or "probable" diagnoses of AE treated at our neurological intensive care unit between 2002 and 2015. We collected and analyzed clinical, paraclinical, laboratory findings and assessed the mortality at last follow-up based on patient records. RESULTS:Twenty-seven patients [median age 55 years (range 25-87), male = 16] were included. Thirteen (48%) had "definite" AE. The most common reasons for admission were status epilepticus (7/27, 26%) and delirium (4/27, 15%). One-year survival was 82%, all five deceased were male, and 3 (60%) of them had "probable" disease. The non-survivors (median follow-up 1 year) were more likely to have underlying cancer and higher need for respiratory support compared to the survivors (p < 0.041, and p = 0.004, respectively). CONCLUSIONS:Clinical presentations and outcomes in critically ill patients with AE are diverse, and the most common leading cause for intensive care unit admission was status epilepticus. The association of comorbid malignancy and the need for mechanical ventilation with mortality deserves further attention.
journal_name
Neurocrit Carejournal_title
Neurocritical careauthors
Harutyunyan G,Hauer L,Dünser MW,Karamyan A,Moser T,Pikija S,Leitinger M,Novak HF,Trinka E,Sellner Jdoi
10.1007/s12028-016-0370-7subject
Has Abstractpub_date
2017-08-01 00:00:00pages
82-89issue
1eissn
1541-6933issn
1556-0961pii
10.1007/s12028-016-0370-7journal_volume
27pub_type
杂志文章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::In this article, we review technologies available for direct monitoring of cerebral oxygenation and metabolic status, including jugular venous oxygen saturation, brain tissue oxygen tension, transcranial cerebral oximetry with near-infrared spectroscopy, Positron emission tomography oxidative metabolism, single-photon...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1385/ncc:4:1:083
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:Lymphopenia is increasingly recognized as a consequence of acute illness and may predispose to infections. We investigated whether admission lymphopenia (AL) is associated with increased risk of infectious complications and poor outcome in patients with spontaneous intracerebral hemorrhage (ICH). METHODS:We...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-016-0367-2
更新日期:2017-04-01 00:00:00
abstract:INTRODUCTION:A case of cefepime-induced nonconvulsive status epilepticus in a 15-year-old child with end stage renal disease on hemodialysis is reported. Clinical symptoms and EEG dramatically improved 48 h after discontinuation of cefepime. METHODS:Twenty-five cases of nonconvulsive status epilepticus associated with...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-008-9166-8
更新日期:2009-01-01 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:Subarachnoid hemorrhage (SAH) has been associated with pronounced acute sympathetic activation. The purpose of this investigation is to identify demographic, clinical, radiological, and anatomical features of SAH that relate to sympathetic activation. METHODS:Observational study of consecutive Grades 3-5 SA...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-012-9673-5
更新日期:2012-06-01 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 primary objectives of this study were to identify patient and community benefits of mandatory intensivist management in a neurocritical care (NCC) unit. Our hospital recently mandated intensivist management for patients admitted to the NCC unit. As one of the only comprehensive stroke centers in Orlando,...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-015-0148-3
更新日期:2015-12-01 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: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::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: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: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:To date, common therapy in patients with intracranial hemorrhage (ICH) includes prophylaxis of seizure using antiepileptic drugs, commonly phenytoin. Phenytoin therapy is associated with a high incidence of cognitive disturbance. Levetiracetam is known to cause less cognitive disruption and may be a suitable...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-010-9341-6
更新日期:2011-08-01 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:BACKGROUND:Animal studies suggested that cerebral mitochondrial cardiolipin phospholipids were released after severe traumatic brain injury (TBI), contributing to the pathogenesis of thromboembolism. OBJECTIVES:To determine the incidence of anti-cardiolipin antibodies after severe TBI and whether this was related to t...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-020-01026-x
更新日期:2020-06-18 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::Amantadine and modafinil are neurostimulants that may improve cognitive and functional recovery post-stroke, but the existing study results vary, and no comprehensive review has been published. This systematic review describes amantadine and modafinil administration practices post-stroke, evaluates timing and impact o...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-020-00977-5
更新日期:2020-08-01 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: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: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:Although hydrocephalus is often treated with permanent cerebrospinal fluid (CSF) shunting during hospitalization for acute aneurysmal subarachnoid hemorrhage (SAH), little is known about the development of delayed hydrocephalus. METHODS:Using administrative data on all visits to nonfederal emergency departm...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-014-0072-y
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:Infection in the intensive care unit (ICU) empirically requires broad-spectrum antibiotics. Imipenem/cilastatin, often reserved for more serious hospital-acquired infections, is thought to be associated with a higher risk of seizures than other penicillins and carbapenems. We sought to evaluate the safety of...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-008-9170-z
更新日期:2009-01-01 00:00:00
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:Intravenous (IV) lacosamide use for status epilepticus has increased in recent years and is recommended for refractory status epilepticus by current guidelines. Per the lacosamide package labeling, the preferred route of administration is diluted and infused over 30-60 min; however, administration ...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-018-0560-6
更新日期:2018-12-01 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: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:INTRODUCTION:Airembolism without obvious trauma or surgery is rare. METHODS:Case report. RESULTS:Four years after resection of a non-small cell lung cancer, a 57-year-old man presented with recurrent episodes of sudden onset neurological deficits. Head computer tomographic (CT) scans suggested air embolism, and furth...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-008-9073-z
更新日期:2008-01-01 00:00:00
abstract::Traumatic brain injury (TBI) is a major cause of death and disability worldwide. In large part critical care for TBI is focused on the identification and management of secondary brain injury. This requires effective neuromonitoring that traditionally has centered on intracranial pressure (ICP). The purpose of this pap...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-014-0048-y
更新日期:2014-12-01 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