Neurocritical care
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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 outcome in patients with SAH. ⋯ Patients with subarachnoid hemorrhage and elevated cTnI are found to have worse neurological status at admission. These patients have a worse neurological outcome and in-hospital mortality.
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Benzodiazepine treatment of life-threatening gamma-hydroxybutyrate (GHB) withdrawal is frequently unsatisfactory. Animal studies suggest strongly that treatment with GABA(B) agonists, such as baclofen, will be a more effective strategy. ⋯ Baclofen, a GABA(B) agonist, may be a useful agent in the treatment of severe GHB withdrawal.
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Multicenter Study Clinical Trial
Effect of endovascular hypothermia on acute ischemic edema: morphometric analysis of the ICTuS trial.
Pilot studies of hypothermia for stroke suggest a potential benefit in humans. We sought to test whether hypothermia decreases post-ischemic edema using CT scans from a pilot trial of endovascular hypothermia for stroke. ⋯ Endovascular hypothermia decreases acute post-ischemic cerebral edema. A larger trial is warranted to determine if it affects final infarct volume and outcome in stroke.
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Comparative Study Clinical Trial
A prospective, observational clinical trial of fever reduction to reduce systemic oxygen consumption in the setting of acute brain injury.
Fever after acute brain injury appears to be a detrimental factor, associated with impaired neurological outcomes. This study assessed physiological changes in systemic oxygen consumption (VO2) during cutaneous cooling after severe brain injury. ⋯ Fever reduction in acute brain injury appears to significantly reduce systemic VO2, but is highly dependent on shivering control.