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 acute stroke treatment. METHODS:This is a multicenter survey among 627 nurses from 132 hospitals in Germany. Questions address the acceptance of disability, importance of aphasia, and the preferred treatment in the hypothetical case of SOS. RESULTS:Modified Rankin Scale (mRS) scores of 1 and 2 were considered acceptable by the majority of all respondents (89.7%). A mRS of 3, 4, and 5 was considered acceptable by 60.0, 15.5, and 1.6%, respectively. DHC was indicated as the treatment of choice in 31.4%. Every third participant considered the presence of aphasia important for treatment decision (33.3%). Older respondents more often refrained from DHC, irrespective of the presence of aphasia (dominant hemisphere p = 0.001, non-dominant hemisphere p = 0.004). Differences regarding acceptable disability and treatment decision were dependent on age, sex, and having relatives with stroke. CONCLUSION:Most German nurses indicate moderately severe disability after SOS not to be acceptable, without emphasizing the presence of aphasia. The results call for greater scientific efforts in order to find reliable predictors for outcome after SOS.
journal_name
Neurocrit Carejournal_title
Neurocritical careauthors
Neugebauer H,Malakou F,Uttner I,Köpke M,Jüttler E,IGNITE Study Group (Initiative of German NeuroIntensive Trial Engagement).doi
10.1007/s12028-018-0586-9subject
Has Abstractpub_date
2019-02-01 00:00:00pages
132-138issue
1eissn
1541-6933issn
1556-0961pii
10.1007/s12028-018-0586-9journal_volume
30pub_type
杂志文章,多中心研究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:BACKGROUND:Cerebral edema is a major cause of mortality following cardiac arrest (CA) and cardiopulmonary resuscitation (CPR). Arginine vasopressin (AVP) and water channel aquaporin-4 (AQP4) have been implicated in the pathogenesis of CA-evoked cerebral edema. In this study, we examined if conivaptan, a V1a and V2 anta...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-015-0236-4
更新日期:2016-04-01 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::Neurocritical care relies on the continuous, real-time measurement of numerous physiologic parameters. While our capability to obtain such measurements from patients has grown markedly with multimodal monitoring in many neurologic or neurosurgical intensive care units (ICUs), our ability to transform the raw data into...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-013-9872-8
更新日期:2014-02-01 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:INTRODUCTION:Bacterial meningitis is associated with a high mortality and a high incidence of neurological sequelae. Parainfectious vasculitis leading to ischemic brain damage is a known complication of bacterial meningitis but its treatment is uncertain. METHODS AND RESULTS:We report the case of a 53-year-old man wit...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1385/NCC:4:3:237
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:Subarachnoid hemorrhage (SAH) is a devastating disease. Nimodipine is the only medical treatment shown to improve outcome of SAH patients. Human albumin (ALB) may exert neuroprotection in SAH. However, current usage of ALB in SAH is not known. We conducted an international survey of clinicians involved in th...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-013-9942-y
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:The initial noncontrast computed tomography (CT) study of the head after an aneurysmal subarachnoid hemorrhage (SAH) is used to predict the risk of developing vasospasm. Changes in the extent of subarachnoid blood seen on CT images occur as a function of time after SAH, but there is no consensus on the time ...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-009-9227-7
更新日期:2009-01-01 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: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:Release of cardiac biomarkers is reported in patients with subarachnoid hemorrhage (SAH). Data addressing the impact of cardiac injury on outcome in these patients is sparse. This study was conducted to ascertain the association of elevation of serum cardiac Troponin-I (cTnI) with mortality and neurological ...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-007-9038-7
更新日期:2008-01-01 00:00:00
abstract::A common observation in closed head injuries is the contrecoup brain injury. As the in vivo brain is less dense than the cerebrospinal fluid (CSF), one hypothesis explaining this observation is that upon skull impact, the denser CSF moves toward the site of skull impact displacing the brain in the opposite direction, ...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1385/NCC:1:3:385
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:Hematoma expansion (HE) occurs in approximately one-third of patients with intracerebral hemorrhage (ICH) and is known to be a strong predictor of neurological deterioration as well as poor functional outcome. This study aims to externally validate three risk prediction models of HE (PREDICT, 9-point, and BR...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-018-0631-8
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:To investigate the effects of hyperbaric oxygen (HBO) on brain damage and autophagy levels in a rat model of middle cerebral artery occlusion. METHODS:Neurologic injury and infarcted areas were evaluated according to the modified neurological severity score and 2,3,5-triphenyltetrazolium chloride staining. ...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-018-0577-x
更新日期:2019-02-01 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::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: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: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:BACKGROUND:Case reports suggest lacosamide may have a role in status epilepticus (SE). The purpose of this case series is to describe the use of lacosamide in refractory SE (RSE) at our institution. METHODS:Observational study of all patients admitted to the neurosciences intensive care unit with RSE who received at l...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-010-9501-8
更新日期:2011-06-01 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:Impaired cerebrovascular reactivity (CR) has been reported to be associated with adverse outcome in patients with aneurysmal subarachnoid hemorrhage (aSAH). However, CR may be determined using different paradigms and it is unclear, which measurement method most suitable reflects the clinical course or is abl...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-009-9287-8
更新日期:2010-04-01 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:Cerebral blood flow (CBF) measurements are helpful in managing patients with traumatic brain injury (TBI), and testing the cerebrovascular reactivity to CO(2) provides information about injury severity and outcome. The complexity and potential hazard of performing CBF measurements limits routine clinical use...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-012-9727-8
更新日期:2014-02-01 00:00:00
abstract:OBJECTIVE:Identification of patients with posterior fossa infarction at risk for neurological deterioration remains a challenge. MRI-based assessments of MCA infarction can predict poor outcome. Similar quantitative imaging measures after cerebellar stroke have not been studied. We tested the hypothesis that MRI-based ...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-013-9886-2
更新日期:2013-12-01 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: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:BACKGROUND:Global cerebral edema (GCE) with subsequent refractory intracranial hypertension complicates some cases of aneurysmal subarachnoid hemorrhage (aSAH), and typically is associated with poorer outcome. Treatment options for refractory intracranial pressure (ICP) cases are limited to decompressive hemicraniectom...
journal_title:Neurocritical care
pub_type: 杂志文章
doi:10.1007/s12028-014-9989-4
更新日期:2014-12-01 00:00:00
abstract::An elevated platelet count may occur during care of neurology/neurosurgical patients and is usually due to reactive or secondary thrombocytosis (ST) caused by inflammation or infection. Primary (clonal) thrombocythemia or essential thrombocythemia associated with myeloproliferative disorders is usually known before or...
journal_title:Neurocritical care
pub_type: 杂志文章,评审
doi:10.1007/s12028-008-9076-9
更新日期:2008-01-01 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::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