The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses
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Review Case Reports
Using transcranial Doppler sonography to augment the neurological examination after aneurysmal subarachnoid hemorrhage.
Vasospasm is the leading cause of death in patients who survive initial subarachnoid hemorrhage (SAH). Evidence of blood in the subarachnoid space on computed tomography (CT) scan can often predict the occurrence of vasospasm. Clinically, the onset of new or worsening neurological symptoms is the most reliable indicator of vasospasm. ⋯ Although vasospasm can only be definitively diagnosed by cerebral angiogram, TCD sonography provides a noninvasive, low-risk assessment tool that can be done at the beside. By coupling a patient's vital neurological data with blood flow velocity trends, the neuroscience nurse can anticipate the onset or worsening of vasospasm. This advanced nursing assessment allows for collaboration with the medical team to initiate and adjust appropriate therapies to improve patient outcomes.
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Randomized Controlled Trial Clinical Trial
Effect of therapeutic hypothermia on the incidence and treatment of intracranial hypertension.
Therapeutic hypothermia initiated immediately after a severe head trauma holds promise for improving outcomes. However, the effect of hypothermia on intracranial pressure (ICP) is not yet known. ⋯ There were no significant differences in the overall incidence or treatment of intracranial hypertension between patients who were treated with therapeutic hypothermia and normal controls. Therapeutic hypothermia maintained the ICP at lower levels during the cooling phase, but once patients were rewarmed, the ICP elevated to the levels of normothermic patients.