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Hernández-Durán S, Meinen L, Rohde V, von der Brelie C. Invasive Monitoring of Intracranial Pressure After Decompressive Craniectomy in Malignant Stroke. Stroke . 2021 Jan;52(2):707-711. doi: 10.1161/STROKEAHA.120.032390. Epub 2020 Dec 4. Reviewed by Shannon Hextrum, MD READ THE ARTICLE* *Article access requires subscription to PubMed Background: Decompressive hemicraniectomy (DC) improves mortality in malignant cerebral infarction (MCI). There is little evidence to guide the use of intracranial pressure (ICP) monitoring in the management of MCI before or after DC. This study examines the utility of postoperative ICP monitoring in DC for ...
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By Teodor Svedung Wettervik & Per Enblad First Online: 27 April 2021 We thank Dr. Schmitt and colleagues for finding our original article “Temporal dynamics of ICP, CPP, PRx, and CPPopt in high-grade aneurysmal subarachnoid hemorrhage and the relation to clinical outcome” [1] interesting and for the important comments. First, pCO2 is a relevant factor to consider because it is an important modulator of cerebral blood flow (CBF) in general and after acute brain injury. Taking into consideration the risk of developing cerebral vasospasm after aneurysmal subarachnoid hemorrhage (aSAH), our management protocol targets normoventilation (pCO2 within 5.5–6.0 kPa), ...
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By Johan Schmitt, Philippe Aries, Marc Danguy Des Deserts & Christophe Giacardi First Online : 27 April 2021 Wettervik et al. [1] recently published a great work titled “Temporal Dynamics of ICP, CPP, PRx, and CPPopt in High-Grade Aneurysmal Subarachnoid Hemorrhage and the Relation to Clinical Outcome.” We read with interest and would like to address some comments. First, the treatment protocol is questionable. An important data point is not provided by the authors: partial pressure of arterial carbon dioxide. On the basis of this retrospective study, results could be biased when excluding this major parameter. Indeed, hypocapnia is now well known as ...
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By Yu-Lun Li, Xin-Ni Lv, Xiao Wei, Wen-Song Yang, Rui Li, Lan Deng, Miao Wei, Qi Li & Fa-Jin Lv First Online : 03 May 2021 Objectives Perihemorrhagic edema (PHE) growth has been gradually considered as predictor for outcome of Intracerebral hemorrhage (ICH) patients. The aim of our study was to investigate correlation between non-contrast computed tomography (CT) markers and early PHE growth. Methods ICH patients between July 2011 and March 2017 were included in this retrospective analysis. ICH and PHE volumes were measured by using a validated semiautomatic volumetric algorithm. Nonparametric test was used for comparing PHE volume at different time ...
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Richard Choi, DO Please note this opinion piece reflects the views of the author and does not necessarily reflect the position of ChristianaCare.   The recent wave of increased social and racial injustice awareness as well as the significant increase in anti-Asian hate crimes 1 have had me reflecting on my life-long cultural and racial experiences.  As a Chinese-Korean American child growing up in Spain in the 80s and 90s, I unfortunately became accustomed to experiencing racist behaviors and slurs such as people holding their eyes in a slanted-eye gesture while yelling ‘Ching Chong.’ In order to blend in, I “white-washed” myself: I refused to speak ...
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Lindner A, Rass V, Ianosi BA, et al. The Importance of PbtO2 Probe Location for Data Interpretation in Patients with Intracerebral Hemorrhage. Neurocritical Care . 2020 Sep 11:1-0.  Reviewed by Wazim Mohamed, MD Read the Article Background : Secondary brain injury after spontaneous intracerebral hemorrhage (ICH) continues to have a significant impact on long-term morbidity and mortality. Brain tissue oxygen tension monitoring (PbtO2) is an additional neuromonitoring modality that may provide insight into the extent of secondary brain injury after ICH, helping to identify targets to improve brain tissue hypoxia (BTH). One of the traditional arguments ...
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By Anthony Figaji First Online: 30 April 2021 Do complex systems improve our care of patients with brain injury? It is easy to argue that they do, at least in concept. The brain is the most complex organ of the human body and even more so when injured. A multitude of pathophysiological changes evolve from primary traumatic brain injury (TBI) and many more from secondary insults, developing a vicious cycle of injury that begets more injury. Moreover, all of our well-meaning attempts to avoid or treat secondary injury can create more trouble, sometimes inadvertently causing further injury. For example, raising blood pressure may reduce the risk of ischemia, ...
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By Wade Smith, MD, PhD, FNCS COVID-19 Vaccinations: Hope Is on the Horizon Dear NCS Members, As hopeful news about COVID-19 vaccines spreads nationwide, we can start looking forward to a safe return to our regular lives. Rates of hospitalizations have fallen across the United States. All states are offering vaccinations to all people over 16 years old. With the Centers for Disease Control allowing domestic travel for those who are fully vaccinated, as well as following recommendations for international travel, many universities are relaxing restrictions on travel for vaccinated faculty and staff. I suspect this will allow for the potential of academic ...
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Title: Neurointensivist at Albany Medical Center Company: Albany Medical Center Department: Neurology and Neurosurgery Position: 3d Neurointensivist - Fellowship Program Director Expertise: Neurocritical Care Fellowship Salary Range: Intensivist and not Neurology-based Description: The Department of Neurology and the Neurosciences Institute of Albany Medical Center is seeking a BC/BE Neurologist with fellowship training in Neurointensive Care. Additional Board Certification in Vascular Neurology is not required, but would be preferred. The successful candidate will join 2 other neurointensivists and a team of dedicated neurovascular interventionalists, ...
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Ryan Hakimi, DO, MS, NVS, RPNI, CPB, FNCS This series will be a running feature highlighting billing, coding, practice management, and other business aspects of neurocritical care.  Although all of us received extensive education and training in the care of neurocritical care patients, few if any of us received any training on the non-patient care aspects of our daily jobs. The goal of this series will be to increase your value as a neurocritical care provider to your organization while improving regulatory compliance and hospital-based metrics. Physician neurointensivists come from a variety of specialties and similarly are housed in a variety of hospital ...
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The Lancet Psychiatry (04/06/21) DOI: 10.1016/S2215-0366(21)00084-5 Taquet, Maxime; Geddes, John R.; Husain, Masud; et al. https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(21)00084-5/fulltext Approximately a third of people diagnosed with COVID-19 exhibited longer term neurological and psychiatric symptoms, a new study shows. For the retrospective cohort study, researchers from the University of Oxford examined the health records of 236,379 patients in the six months following their COVID-19 diagnosis and estimated the incidence of 14 neurological and psychiatric outcomes during that time. The estimated incidence of any neurological or ...
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Title: Neurointensivist - Advocate Christ Medical Department: Neurology Position: Neurointensivist Attending Expertise: Neurocritical Care Salary Range: Competitive Description: Advocate Aurora Health is the market leader in Neurosciences in the Chicagoland area with a system platform of over 100 neuroscience physicians and advanced practice clinicians. Advocate Christ Medical Center provides the highest level of neurological care in a patient centered environment for the 18-bed dedicated/closed Neuro Intensive Care Unit. Designated Comprehensive Stroke Center 24/7 Neuroendovascular coverage Collaborative efforts between Neurosurgery, ...
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By Ethan G. Lester, Ryan A. Mace, Sarah M. Bannon, Paula J. Popok, Melissa V. Gates, Emma Meyers, Tara Tehan, Danielle Sagueiro, Jonathan Rosand, Eric A. Macklin & Ana-Maria Vranceanu First online : 21 April 2021 Background Neuro-ICU hospitalization for an acute neurological illness is often traumatic and associated with heightened emotional distress and reduced quality of life (QoL) for both survivors and their informal caregivers (i.e., family and friends providing unpaid care). In a pilot study, we previously showed that a dyadic (survivor and caregiver together) resiliency intervention (Recovering Together [RT]) was feasible and associated with sustained ...
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By David Emmanuel Duhaut, Catherine Heurteaux, Carine Gandin, Carole Ichai & Hervé Quintard First online: 20 April 2021 Background Sodium lactate (SL) has been described as an efficient therapy in treating raised intracranial pressure (ICP). However, the precise mechanism by which SL reduces intracranial hypertension is not well defined. An antiedematous effect has been proposed but never demonstrated. In this context, the involvement of chloride channels, aquaporins, or K–Cl cotransporters has also been suggested, but these mechanisms have never been assessed when using SL. Methods In a rat model of traumatic brain injury (TBI), we compared the ...
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By Giorgia Carra, Francesca Elli, Bogdan Ianosi, Marine Flechet, Lukas Huber, Verena Rass, Bart Depreitere, Fabian Güiza, Geert Meyfroidt, Giuseppe Citerio & Raimund Helbok First online : 12 April 2021 Background In patients with aneurysmal subarachnoid hemorrhage (aSAH) the burden of intracranial pressure (ICP) and its contribution to outcomes remains unclear. In this multicenter study, the independent association between intensity and duration, or “dose,” of episodes of intracranial hypertension and 12-month neurological outcomes was investigated. Methods This was a retrospective analysis of multicenter prospectively collected data of 98 adult patients ...
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By Corinna N. Lang, Johanna S. Dettinger, Michael Berchtold-Herz, Stefan Utzolino, Xavier Bemtgen, Viviane Zotzmann, Bonaventura Schmid, Paul M. Biever, Christoph Bode, Katharina Müller-Peltzer, Daniel Duerschmied, Tobias Wengenmayer, Wolf-Dirk Niesen & Dawid L. Staudacher First Online : 12 April 2021 This abstract of this article was updated to correct the following sentence to read: ICH was detected in 22 patients (13.5%) with no statistical difference between the groups (11.2 vs. 19.1% without and with SARS-CoV-2, respectively, p = 0.21). Propensity score matching confirmed similar rates of ICH in both groups (12.8 vs. 19.1% without and with SARS‐CoV‐2, ...
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By Andrew J. Webb, Caitlin S. Brown, Ryan M. Naylor, Alejandro A. Rabinstein, Kristin C. Mara & Andrea M. Nei First online: 12 April 2021 Background Coagulopathy in traumatic brain injury (TBI) is associated with increased risk of poor outcomes, but accurate prediction of clinically significant progressive hemorrhagic injury (PHI) in patients with severe TBI remains a challenge. Thromboelastography (TEG) is a real-time test of whole blood coagulation that provides dynamic information about global hemostasis. This study aimed to identify differences in TEG values between patients with severe TBI who did or did not experience clinically significant PHI. ...
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Growing NCC team, hiring physicians Company: OhioHealth Department: Neurosciences Position: Neurointensivist Expertise: Neurocritical Care Region: Midwest Description: Join a well-respected group of nationally known neurointensivists in a thriving, family-friendly city. OhioHealth is seeking a Neurointensivist to join its neuroscience service line in Columbus, OH. Position profile: What can you expect? Alternating coverage between OhioHealth’s two largest hospitals, Riverside Methodist and Grant Medical Center See a wide range of cases in our amply staffed 32 bed “closed” model Neuro Critical Care Unit at Riverside, which is the ...
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Curing Coma Campaign Mission Control Keri S. Kim, PharmD, MS CTS Shraddha Mainali, MD Len Polizzotto, PhD Jose Suarez, MD, FNCS, FANA Claude Hemphill, MD, MAS, FNCS Daiwai Olson, PhD, RN, FNCS The Curing Coma Campaign (CCC) is a global public health initiative with an overarching goal of developing and implementing diagnostic, therapeutic and prognostic strategies to improve the lives of patients with coma and disorders of consciousness. World Coma Day, an initiative of the CCC was organized as a virtual event targeting a global audience and is a part of an ongoing clinical and scientific endeavor to improve ...
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Title: Neurocritical Care Physician - Phoenix, AZ 13179BR Company: TEAMHealth Position: Neurocritical Care Physician Region: West Description: TeamHealth is seeking a board certified or board eligible neurocritical care trained physician to join us at Abrazo Central Campus in Phoenix, Arizona. Neurosciences is a significant focus for the Abrazo Central Campus and they continue investing in the capabilities for neurosurgery and stroke treatment. The neuro ICU at Central Campus is a dedicated 7-bed ICU focused on delivering the highest quality specialized care to patients with all types of neurosurgical and neurological injuries, including stroke, ...
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