Neurocritical care
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Multicenter Study Observational Study
No exacerbation of perihematomal edema with intraventricular tissue plasminogen activator in patients with spontaneous intraventricular hemorrhage.
In severe spontaneous intraventricular hemorrhage (IVH), intraventricular (IVR) administration of tissue plasminogen activator (rtPA) clears blood from the ventricles more rapidly than with external ventricular drainage (EVD) alone. However, experimental studies suggest tPA may be neurotoxic in compromised brain tissue and may exacerbate perihematomal edema. ⋯ For case matched large IVH with small ICH volume, IVR tPA enhances lysis of intraventricular blood clots and has no significant impact on PHE.
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Multicenter Study Observational Study
Clinical outcomes following prolonged refractory status epilepticus (PRSE).
To define the clinical profile and outcome of patients in prolonged refractory status epilepticus (PRSE), and investigate possible predictors of outcome. ⋯ Good outcome is not unusual in PRSE, including in some older patients, in a variety of diagnoses, and despite months of coma.
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Aneurysmal subarachnoid hemorrhage (aSAH) is a neurologic emergency that typically warrants initial monitoring in a critical care setting. The aim of this study is to identify clinical and radiologic features on admission that predict a protracted critical care admission following aSAH. ⋯ We have identified several early risk factors associated with a prolonged critical care stay following aSAH.
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Since the first description of Hashimoto's Encephalitis (HE) in 1966 by Lord Brain, the number of reported cases has continued to increase. In addition, cases of status epilepticus have been reported, suggesting a role for intensive care unit (ICU) practitioners in taking care of patients with HE. ⋯ ICU practitioners should be aware of this disease, since it can include life-threatening presentations.
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Do survivors of acute neurologic injury remember their stay in the neuroscience intensive care unit?
Patients in medical, surgical, and trauma intensive care units (ICUs) are at risk for later development of symptoms of post-traumatic stress disorder (PTSD). Because acute brain injury can impair recall; we sought to show that neuroscience patients undergoing prolonged neuroscience ICU admission have limited memory of their ICU stay and thus are less likely to develop symptoms of PTSD. ⋯ Patients requiring prolonged neuroscience ICU admission do not appear to be traumatized by their ICU stay.