Neurocritical care
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Subdural hematomas are not infrequent among patients with hematologic disorders as they are prone to thrombocytopenia from their disease and chemotherapy. However, rarely these patients can also have leukemic involvement of the subdural space. ⋯ Myeloid sarcoma can mimic subdural hematoma both clinically and radiologically. It should be considered when a patient with a prior leukemia and no antecedent trauma presents with an extra-axial lesion.
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To determine the incidence of withdrawal of life-sustaining treatment in various groups of patients in a mixed intensive care unit (ICU). ⋯ In 83, 7% of patients who die in the mixed ICU life-sustaining treatment is withdrawn. Severe cerebral damage was the leading reason to withdraw life-sustaining treatment.
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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. ⋯ LIS can reveal BAVS. Its diagnosis relies on clinical examination. In this case, rapid neuro-interventional treatment permitted reversal of symptoms. This could not have been possible under sedation.
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In the setting of head trauma, progressive bradycardia may raise suspicion for intracranial hypertension, especially when accompanied by pupillary abnormalities or systemic hypertension. ⋯ Clinicians should be aware that the oculocardiac reflex might mimic signs of intracranial hypertension in patients with combined facial and cerebral trauma.