Abstract:
IMPORTANCE:The pathophysiological mechanisms of Posterior Reversible Encephalopathy Syndrome (PRES) and related seizures remain poorly understood. The prevalence and clinical significance of nonconvulsive seizures (NCSz) and related epileptiform patterns during continuous electroencephalography monitoring (CEEG) in PRES have not been well described. OBJECTIVE:To report the prevalence, characteristics and risk factors for NCSz and related highly epileptiform patterns in patients with PRES, and to determine their relation to imaging abnormalities and outcome. DESIGN, SETTING AND PARTICIPANTS:From a prospective CEEG database, we retrospectively identified patients with PRES and reviewed their medical charts. Based on CEEG findings, we designed a retrospective cohort study comparing two groups defined based on the presence or the absence of NCSz and/or periodic discharges (PDs). MAIN OUTCOMES AND MEASURES:The prevalence and risk factors for PDs and NCSz, description of EEG and magnetic resonance imaging (MRI) abnormalities and functional outcome as measured by the Glasgow Outcome Scale (GOS) at hospital discharge. RESULTS:Among 37 eligible patients, 23 (62%) had PDs or NCSz. The presence of NCSz was associated with the presence of PDs (15/22 vs. 1/15; p = 0.0002). NCSz and PDs were usually either lateralized or bilateral independent and predominated in the posterior regions. No clinical features were associated with the occurrence of PDs or NCSz. Cortical restricted diffusion on MRI was more frequent in the PDs/NCSz group (17/23 vs. 1/14; p < 0.001). PDs/NCSz were associated with worse outcome, with 3 deaths vs. 0 in the no PDs/NCSz group and fewer cases with low disability (4 vs. 9 cases with GOS = 5, p < 0.04). CONCLUSIONS AND RELEVANCE:Our results reveal a high prevalence of NCSz and PDs in critically ill patients with PRES and an association with restricted diffusion and worse outcome, whether treating or preventing these EEG findings can improve outcome requires further research.
journal_name
Neurocrit Carejournal_title
Neurocritical careauthors
Bastide L,Legros B,Rampal N,Gilmore EJ,Hirsch LJ,Gaspard Ndoi
10.1007/s12028-018-0548-2subject
Has Abstractpub_date
2018-12-01 00:00:00pages
481-490issue
3eissn
1541-6933issn
1556-0961pii
10.1007/s12028-018-0548-2journal_volume
29pub_type
杂志文章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:PURPOSE:The objective of our trial was to obtain more comprehensive data on the risks and benefits of kinetic therapy in intensive care patients with intracerebral pathology. METHODS:Standardized data of prone positioning in our NeuroIntensive Care Unit were collected from 2007 onward. A post hoc analysis of all avail...
journal_title:Neurocritical care
pub_type: 临床试验,杂志文章
doi:10.1007/s12028-014-0004-x
更新日期:2014-10-01 00:00:00
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::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:INTRODUCTION:Patients with acute neurological illness may be hypercatabolic. The Harris-Benedict Equation (HBE) is used to estimate energy needs in acute stroke. A "stress factor" for stroke does not exist, and it is not known if the HBE accurately estimates the energy expenditure needs in acute ischemic or hemorrhagic...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1385/NCC:1:3:331
更新日期:2004-01-01 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: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: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: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: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::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::Advanced hemodynamic monitoring is necessary for many patients with acute brain and/or spinal cord injury. Optimizing cerebral and systemic physiology requires multi-organ system function monitoring. Hemodynamic manipulations are cardinal among interventions to regulate cerebral perfusion pressure and cerebral blood f...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-011-9568-x
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:Intrahospital transport is associated with a high rate of complications. Investigations of this problem using neuromonitoring remain scarce. METHODS:This is a monocentric, prospective observational study. Patients with severe brain diseases and intracranial pressure (ICP) monitoring were included. Continuou...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-016-0274-6
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:Brain tissue hypoxia (PbtO2 < 20 mmHg) is common after subarachnoid hemorrhage (SAH) and associated with poor outcome. Recent data suggest that brain oxygen optimization is feasible and reduces the time spent with PbtO2 < 20 mmHg from 45 to 16% in patients with severe traumatic brain injury. Here, we intende...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-019-00753-0
更新日期:2019-10-01 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
abstract:BACKGROUND:The most widely used and most studied coma score to date is the Glasgow Coma Scale (GCS), which is used worldwide to assess level of consciousness and predict outcome after traumatic brain injury (TBI). Our aim was to determine whether the Full Outline of UnResponsiveness (FOUR) score is an accurate predicto...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-011-9617-5
更新日期:2012-02-01 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::A growing body of clinical literature emphasizes the impact of cerebral edema in early brain injury following aneurysmal subarachnoid hemorrhage (aSAH). Aneurysm rupture itself initiates global cerebral edema in up to two thirds of cases. Although cerebral edema is not a universal feature of aSAH, it portends a poor c...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-016-0354-7
更新日期:2017-04-01 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: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::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:INTRODUCTION:Altered mental status and more subtle cognitive and personality changes after traumatic brain injury (TBI) are pervasive problems in patients who survive initial injury. MRI is not necessarily part of the diagnostic evaluation of these patients. METHODS:Case report with relevant image and review of the li...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-012-9699-8
更新日期:2012-06-01 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:Sedation and therapeutic hypothermia (TH) delay neurological responses and might reduce the accuracy of clinical examination to predict outcome after cardiac arrest (CA). We examined the accuracy of quantitative pupillary light reactivity (PLR), using an automated infrared pupillometry, to predict outcome of...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-014-9981-z
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:The natural history of cerebral aneurysms derived from metastatic spread of cardiac myxomas is not well known, and their management presents many dilemmas. METHODS:Case report and literature review. RESULTS:An 18-year-old man presented with an intraparenchymal hemorrhage several months after resection of a...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-010-9400-z
更新日期:2010-10-01 00:00:00
abstract::Traumatic spine injuries (TSIs) carry significantly high risks of morbidity, mortality, and exorbitant health care costs from associated medical needs following injury. For these reasons, TSI was chosen as an ENLS protocol. This article offers a comprehensive review on the management of spinal column injuries using th...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-015-0169-y
更新日期:2015-12-01 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: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: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::Traumatic brain injury (TBI) was chosen as an Emergency Neurological Life Support topic due to its frequency, the impact of early intervention on outcomes for patients with TBI, and the need for an organized approach to the care of such patients within the emergency setting. This protocol was designed to enumerate the...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-012-9760-7
更新日期:2012-09-01 00:00:00