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 with definite and possible NSC were included. Data on patient demographics, baseline clinical information, cardiac function, and laboratory values were collected. Outcomes included length of stay, modified Rankin Scale (mRS) at discharge and long-term follow-up. Continuous variables were compared using a student's t test, and categorical variables were compared using a Chi-square test. RESULTS:Among 34 patients included in the study, the most common presenting symptom was dyspnea (17 patients, 50%). Subarachnoid hemorrhage (SAH) was the most common neurological inciting event (11 patients, 32.4%), but two-thirds of this cohort had other neurological triggers. The most common electrocardiogram changes were QT-interval prolongation (30 patients, 88.2%) and T-wave inversion (22 patients, 64.7%). The most common echocardiographic pattern was the apical variant (14 patients, 41.2%), and 26% of patients had right ventricular involvement (P = 0.03) which was a predictor of poor outcome along with inotropic support (P = 0.006). Functional outcome was poor (mRS > 3) in 53% of patients at discharge, but function improved over time in most survivors. CONCLUSIONS:NSC is most common after SAH, but can result from a wide spectrum of acute brain insults. Requirement of inotropic support was the strongest indicator of prognosis at last follow-up. Patients with NSC often have poor function at discharge but many improve over time.
journal_name
Neurocrit Carejournal_title
Neurocritical careauthors
Nasr DM,Tomasini S,Prasad A,Rabinstein AAdoi
10.1007/s12028-017-0412-9subject
Has Abstractpub_date
2017-12-01 00:00:00pages
356-361issue
3eissn
1541-6933issn
1556-0961pii
10.1007/s12028-017-0412-9journal_volume
27pub_type
杂志文章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: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:Currently, continuous electroencephalographic monitoring (cEEG) is the only available diagnostic tool for continuous monitoring of brain function in intensive care unit (ICU) patients. Yet, the exact relevance of routinely applied ICU cEEG remains unclear, and information on the implementation of cEEG, espec...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-018-0525-9
更新日期:2018-10-01 00:00:00
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::The objective of this study was to determine the prevalence of intracranial hypertension (IHT) and the associated mortality rate in patients who suffered from primary intracerebral hemorrhage (ICH). A secondary objective was to assess predisposing factors to IHT development. We conducted a systematic literature search...
journal_title:Neurocritical care
pub_type: 杂志文章,meta分析
doi:10.1007/s12028-018-0658-x
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:Infection is common following stroke and is independently associated with worse outcome. Clinical studies suggest that infections occur more frequently in those individuals with stroke-induced immunologic dysfunction. This study sought to explore the contribution of immunomodulatory cytokines and hormones to...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-010-9490-7
更新日期:2011-04-01 00:00:00
abstract:INTRODUCTION:Delayed ischemic deficit from vasospasm is a leading cause of morbidity and mortality after aneurysmal subarachnoid hemorrhage. Although several treatment modalities have been used to reverse the deleterious effects of vasospasm, alternative therapies are needed, as conventional therapies are often ineffec...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-007-9017-z
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::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::This review examines the available data on the use of osmotic agents in patients with head injury and ischemic stroke, summarizes the physiological effects of osmotic agents, and presents the leading hypotheses regarding the mechanism by which they reduce ICP. Finally, it addresses the validity of the following common...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1385/NCC:1:2:219
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:This prospective study of an innovative non-invasive ultrasonic cerebrovascular autoregulation (CA) monitoring method is based on real-time measurements of intracranial blood volume (IBV) reactions following changes in arterial blood pressure. In this study, we aimed to determine the clinical applicability o...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-018-0569-x
更新日期:2019-02-01 00:00:00
abstract::Prophylactic use of hypervolemia and hypertension is believed to present an option to decrease the incidence of symptomatic vasospasm after aneurysmal subarachnoid hemorrhage and improve neurologic outcome. A Medline literature search was conducted to review available evidence regarding volume management after subarac...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-011-9593-9
更新日期:2011-09-01 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:BACKGROUND:Burst suppression in mechanically ventilated intensive care unit (ICU) patients is associated with increased mortality. However, the relative contributions of propofol use and critical illness itself to burst suppression; of burst suppression, propofol, and critical illness to mortality; and whether preventi...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-020-00932-4
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:Terson's syndrome is intraocular hemorrhage (IOH) subsequent to subarachnoid hemorrhage (SAH). Its presence is associated with higher mortality in SAH. We report a case of Terson's syndrome and review the literature. CASE REPORT:A 71-year-old Caucasian gentleman collapsed and became comatose. Past medical h...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-011-9555-2
更新日期:2011-12-01 00:00:00
abstract::Sleep is fundamental for everyday functioning, yet it is often negatively impacted in critically ill patients by the intensive care setting. With a focus on the neurological intensive care unit (NeuroICU), this narrative review summarizes methods of measuring sleep and addresses common causes of sleep disturbance in t...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-019-00795-4
更新日期:2020-04-01 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: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:PURPOSE:One study found higher leukocytes 8-hydroxy-2'-deoxyguanosine (8-OHdG) levels in patients with spontaneous intracerebral hemorrhage (ICH) than in healthy subjects due to the oxidation of guanosine from deoxyribonucleic acid (DNA). The objective of this study was to determine whether there is an association betw...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-019-00864-8
更新日期:2020-08-01 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::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: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: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::Multi-modal monitoring has become an integral part of neurointensive care. However, our approach is at this time neither standardized nor backed by data from randomized controlled trials. The goal of the second Neurocritical Care Research Conference was to discuss research priorities in multi-modal monitoring, what re...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-015-0134-9
更新日期:2015-06-01 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: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:INTRODUCTION:Levetiracetam (LEV) is used in the setting of acute brain injury for seizure treatment or prophylaxis but its safety and efficacy in this setting is unknown. METHOD:We retrospectively analyzed the patterns of use and safety/efficacy of LEV in 379 patients treated in the neuroscience intensive care unit (N...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-007-0042-8
更新日期:2007-01-01 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:An alternation of sympathetic and vagal nervous activity has been suggested to be one possible mechanism of neurogenic pulmonary edema (NPE) in patients with subarachnoid hemorrhage (SAH). The study aimed to explore if sympathovagal modulation assessed by frequency domains of heart rate variability (HRV) is ...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-015-0237-3
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Target blood pressure (BP) in stable (non-hypotensive) patients with acute isolated blunt traumatic intracranial hemorrhage (TICH) is unknown. To address this issue, our study correlated BP with radiological volumetric progression (RP) and neurological deterioration (ND) in these patients. METHODS:A retrosp...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-014-9957-z
更新日期:2014-08-01 00:00:00