Abstract:
OBJECTIVES:Hourly neurologic assessments for traumatic brain injury (TBI) in the critical care setting are common practice but prolonged use may actually be harming patients through sleep deprivation. We reviewed practice patterns at our institution in order to gain insight into the role of frequent neurological assessments. METHODS:A 6-month retrospective review was performed for patients who were admitted to an intensive care unit (ICU) with the diagnosis of TBI. Electronic medical records were reviewed based on billing codes. Variables collected included but were not limited to patient demographics, frequency of nursing neurologic evaluations, Glasgow coma scale (GCS), length of stay (LOS), and disposition. RESULTS:A total of 124 patients were identified, 71% male with the average age of 52 years (range 19-96). Traumatic brain injury was classified as severe in 44, moderate in 18, and mild in 62 patients. A total of 89 (71.8%) patients underwent hourly nursing assessments for an average of 2.82 days. The median LOS for all patients was 7 days (range 0-109). There were 18 patients who remained on hourly neurological assessments for greater than 4 days and had a greater LOS (23 days vs 9 days, P = 0.001). Only two patients required surgery after 48 hours, both for chronic subdural hematomas. DISCUSSION:Hourly neurologic checks are necessary in the acute period for patients with potentially expansible intracranial hemorrhages or malignant cerebral edema, but prolonged use may be harmful. Patients with a low probability of requiring neurosurgical intervention may benefit from reducing the total duration of hourly assessments.
journal_name
Neurol Resjournal_title
Neurological researchauthors
Stone JJ,Childs S,Smith LE,Battin M,Papadakos PJ,Huang JHdoi
10.1179/1743132813Y.0000000285subject
Has Abstractpub_date
2014-02-01 00:00:00pages
164-9issue
2eissn
0161-6412issn
1743-1328journal_volume
36pub_type
杂志文章abstract:OBJECTIVE:It is difficult for the treatment of neurologic tumors with current therapies, including glioma. Despite the advances in cancer therapeutics, the outcomes in these patients remain poor and, therefore, new modalities are required. Recent findings have demonstrated that human umbilical cord blood mesenchymal st...
journal_title:Neurological research
pub_type: 杂志文章
doi:10.1179/016164110X12816242542490
更新日期:2011-05-01 00:00:00
abstract::The objective of this study was to improve the ability to detect cerebrovascular complications in patients undergoing complicated neurosurgical procedures using on-line monitoring of cerebral pH with in vivo microdialysis. We employed on-line pH monitoring in patients with a variety of neurosurgical procedures includi...
journal_title:Neurological research
pub_type: 杂志文章
doi:10.1080/01616412.1998.11740497
更新日期:1998-03-01 00:00:00
abstract:OBJECTIVE:Elevated homocysteine level is a risk factor for ischemic stroke and associated with small vessel disease such as confluent leukoaraiosis in white and black population. We investigated the relationship between the total serum homocysteine level and ischemic stroke subtypes in Chinese population. METHODS:Thre...
journal_title:Neurological research
pub_type: 杂志文章
doi:10.1179/016164109X12445616596445
更新日期:2010-07-01 00:00:00
abstract::To study the pathophysiology of olivopontocerebellar atrophy (OPCA), we destroyed inferior olive nuclei of male Wistar rats using 3-acetyl pyridine (3-AP) + harmaline + niacinamide. These rats showed a sluggish and ataxic gait. To elucidate the relationship between thyrotropin releasing hormone (TRH) in the Purkinje c...
journal_title:Neurological research
pub_type: 杂志文章
doi:10.1080/01616412.2000.11740690
更新日期:2000-06-01 00:00:00
abstract::Ninety percent of cerebral aneurysms were diagnosed after their first rupture with consecutive subarachnoid haemorrhage. In order to detect the aneurysms before rupture investigation by transcranial Doppler sonography was used on the basis of intra-operative evaluation of the normal aneurysmal flow pattern. In 34 pati...
journal_title:Neurological research
pub_type: 杂志文章
doi:10.1080/01616412.1989.11739860
更新日期:1989-03-01 00:00:00
abstract:OBJECTIVE:Computed tomographic angiography (CTA) was invented more than 20 years ago, but only gained acceptance recently, thanks to advancements in the computer technology. It can demonstrate areas of arterial stenosis or occlusion with accuracy nearly that of digital subtraction angiography (DSA). It is also able to ...
journal_title:Neurological research
pub_type: 杂志文章
doi:10.1179/174313208X340969
更新日期:2008-10-01 00:00:00
abstract:OBJECTIVE:To investigate mechanisms behind the faster rehabilitation of limb fractures when associated with traumatic brain injury (TBI). METHODS:New Zealand rabbits were divided into TBI group and sham-operation group for four studies as follows: (1) blood and cerebrospinal fluid (CSF) were drawn on days 1, 3, and 7 ...
journal_title:Neurological research
pub_type: 杂志文章
doi:10.1179/1743132813Y.0000000201
更新日期:2013-06-01 00:00:00
abstract::Aspirin and ticlopidine are two commonly used drugs in the prevention of cerebral embolic ischemic events. No direct comparisons in a cross-over design of the effects of ticlopidine and aspirin on asymptomatic circulating cerebral microemboli are available. We investigated 53 patients with cerebrovascular disease. Twe...
journal_title:Neurological research
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1080/01616412.1996.11740450
更新日期:1996-10-01 00:00:00
abstract:OBJECTIVES:We attempted to determine whether a functional polymorphism of TRPM6 (rs2274924) is associated with susceptibility to epilepsy following ischemic stroke, and to further explore the effect of this polymorphism on serum levels of Mg2+ in post-stroke patients. METHODS:We carried out a case-control study on 378...
journal_title:Neurological research
pub_type: 杂志文章
doi:10.1080/01616412.2019.1568755
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Multiple sclerosis (MS) is a common inflammatory disease of the central nervous system. A contribution from complement has long been suspected. We investigated the association of complement factor H (CFH) Tyr402 His gene polymorphism and serum level in Egyptian patients with MS to examine whet...
journal_title:Neurological research
pub_type: 杂志文章
doi:10.1179/1743132815Y.0000000075
更新日期:2015-10-01 00:00:00
abstract::Objective The aim of the study was to evaluate the parameters for localizing the seizure onset zone in refractory epilepsy patients using cortico-cortical evoked potentials (CCEP). Methods Fifteen patients (nine females) with medically refractory partial epilepsy underwent stereo electro encephalography (SEEG) in Tsin...
journal_title:Neurological research
pub_type: 杂志文章
doi:10.1080/01616412.2018.1454092
更新日期:2018-06-01 00:00:00
abstract::We have reliable data on the degree of stenosis above which endarterectomy for symptomatic carotid stenosis is beneficial, but benefit is also influenced by other factors, particularly age, sex, the timing of surgery, plaque surface morphology and the nature of the presenting symptomatic event(s). This review will con...
journal_title:Neurological research
pub_type: 杂志文章,评审
doi:10.1179/016164105X25298
更新日期:2005-01-01 00:00:00
abstract::We investigated the neuroprotective effects of a novel 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitor (pitavastatin) on ischemic neuronal damage in gerbils using immunohistochemistry. The animals were allowed to survive for 14 days after 5 min of ischemia induced by bilateral occlusion of the comm...
journal_title:Neurological research
pub_type: 杂志文章
doi:10.1179/016164104225014102
更新日期:2004-09-01 00:00:00
abstract::Recent publications have suggested that intra-ocular pressure (IOP) may be an indirect assessment of intra-cranial pressure (ICP). Both IOP and ICP have similar physiologic pressure ranges and similar responses to changes in intra-abdominal, intra-thoracic and aortic pressure. Previous studies have demonstrated the re...
journal_title:Neurological research
pub_type: 杂志文章
doi:10.1080/01616412.1999.11740925
更新日期:1999-04-01 00:00:00
abstract:OBJECTIVES:One of the main obstacles of electrode implantation in epilepsy surgery is the electrode shift between implantation and the day of explantation. We evaluated this possible electrode displacement using intraoperative MRI (iopMRI) data and CT/MRI reconstruction. METHODS:Thirteen patients (nine female, four ma...
journal_title:Neurological research
pub_type: 杂志文章
doi:10.1080/01616412.2018.1484588
更新日期:2018-10-01 00:00:00
abstract::We examined the microsurgical anatomy of the supratentorial subarachnoid cisterns with a surgical microscope in 20 brains prepared using the immersion technique. The adult brains were immersed in Ringer's solution and air was injected into the subarachnoid cisterns while the brains remained submerged in solution. We i...
journal_title:Neurological research
pub_type: 杂志文章
doi:10.1080/01616412.1994.11740266
更新日期:1994-12-01 00:00:00
abstract::Promyelocytic leukemia (PML) protein is involved in apoptotic death of cultured neuronal cells, but its role in ischemic brain damage remains uncertain. In this study, we investigated change of immunoreactivity for PML protein in rat brain after transient middle cerebral artery occlusion, and compared the results with...
journal_title:Neurological research
pub_type: 杂志文章
doi:10.1179/016164101101199162
更新日期:2001-10-01 00:00:00
abstract:OBJECTIVE:This study investigated the role of matrix metalloproteinase-9 (MMP-9) in early brain injury after subarachnoid hemorrhage (SAH). METHOD:Sprague-Dawley male rats (n=36) weighing between 250 and 300 g were used. SAH was produced by injecting autologous arterial blood into the pre-chiasmatic cistern. MMP-9 pro...
journal_title:Neurological research
pub_type: 杂志文章
doi:10.1179/016164109X12478302362491
更新日期:2010-09-01 00:00:00
abstract:OBJECTIVE:To evaluate by MR diffusion weighted image (DWI-MR) the presence of new ischemic cerebral lesions after carotid artery stenting (CAS) and distal cerebral protection, in patients with internal carotid artery (ICA) stenosis >70. METHODS:Sixty-seven CAS were performed under cerebral protection with a distal fil...
journal_title:Neurological research
pub_type: 杂志文章
doi:10.1179/016164105X35431
更新日期:2005-01-01 00:00:00
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journal_title:Neurological research
pub_type: 临床试验,杂志文章
doi:10.1080/01616412.2000.11740680
更新日期:2000-06-01 00:00:00
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journal_title:Neurological research
pub_type: 杂志文章
doi:10.1179/016164105X49229
更新日期:2006-12-01 00:00:00
abstract:OBJECTIVES:Surgical management of tumors in the sacropelvic region is a challenging field of spine surgery because of the region's complex local anatomy and biomechanics. Recent developments in anesthesia and intensive care have allowed us to perform extended surgeries focused on the en bloc resection of sacropelvic tu...
journal_title:Neurological research
pub_type: 杂志文章,评审
doi:10.1179/1743132814Y.0000000370
更新日期:2014-06-01 00:00:00
abstract::We examined the effect of local anaesthesia of the skin on somatosensory evoked potentials (SEPs) and psychophysical magnitude estimates for a constant intensity air-puff stimulation (7 kg.cm-2) in 23 normal subjects. Before and after intradermal injection (0.1 ml of 1% xylocain) to the tip of the right index finger, ...
journal_title:Neurological research
pub_type: 杂志文章
doi:10.1080/01616412.1995.11740283
更新日期:1995-02-01 00:00:00
abstract::Objectives: Natalizumab (NTZ), a treatment indicated for patients with highly active Relapsing - Remitting Multiple Sclerosis (RRMS), is known to induce increased relative frequency of lymphocytes. Progressive Multifocal Leukoencephalitis (PML) is a rare but serious adverse event related to NTZ. Moreover, reduced L-se...
journal_title:Neurological research
pub_type: 杂志文章
doi:10.1080/01616412.2020.1722913
更新日期:2020-03-01 00:00:00
abstract::Monitoring of regional cerebral oxygen saturation (r. cereb. O2 satn.) was carried out continuously in 12 healthy subjects (mean age 35.2 +/- 4.4 years; range 26-41 years; 4 women, 8 men), prior to, during and following acupuncture. Measurements were obtained with the INVOS 3100 cerebral oximeter (Somanetics Corp., Tr...
journal_title:Neurological research
pub_type: 杂志文章
doi:10.1080/01616412.1998.11740605
更新日期:1998-01-01 00:00:00
abstract:OBJECTIVES:We tested whether repetitive magnetic stimulation (rMS) induces an afferent input to the spinocerebral tract in patients with complex regional pain syndrome (CRPS). METHODS:Cortical and spinal motor evoked potentials (cMEP and sMEP), as well as the contra- and ipsilateral silent period (cCSP and iCSP), were...
journal_title:Neurological research
pub_type: 临床试验,杂志文章
doi:10.1179/016164105X17224
更新日期:2005-06-01 00:00:00
abstract:OBJECTIVE:To explore the risk factors for stroke-associated pneumonia (SAP). METHODS:A retrospective research study was carried out to investigate the clinical data of 1435 patients admitted to the neurological intensive care unit at our university hospital between 1 January 2000 and 31 December 2009. RESULTS:A multi...
journal_title:Neurological research
pub_type: 杂志文章
doi:10.1179/016164111X13007856084205
更新日期:2011-06-01 00:00:00
abstract::Cerebral blood flow (CBF), 113mIndium-DPTA, and 14C-glucose extraction were measured simultaneously in rat brain from 2 to 58 days following a thermal insult. In the early stage of a cold induced lesion (2 days), the blood-brain barrier (BBB) was disrupted with resulting leakage and diffusionary loss of both glucose a...
journal_title:Neurological research
pub_type: 杂志文章
doi:10.1080/01616412.1980.11739556
更新日期:1980-01-01 00:00:00
abstract:OBJECTIVE:To explore whether intracranial pulse pressure amplitudes relate to arterial pulse pressure amplitudes and whether correlations between time-related changes in intracranial and arterial pulse pressure amplitudes associate with indices of cerebral autoregulation. METHODS:A total of 257 continuous and simultan...
journal_title:Neurological research
pub_type: 杂志文章
doi:10.1179/016164107X172167
更新日期:2007-09-01 00:00:00
abstract::A 51-year-old man presented with loss of consciousness when he underwent urological examination at another hospital. CT scans showed subarachnoid hemorrhage, and cerebral angiography showed bilateral dissecting aneurysms of the vertebral arteries. Following ventricular drainage, the lesion was managed conservatively w...
journal_title:Neurological research
pub_type: 杂志文章
doi:10.1179/016164102101200825
更新日期:2002-12-01 00:00:00