Metabolic Encephalopathies
Figure 78.1. Algorithm for the unresponsive patient. * Tests for metabolic disorder: EEG, laboratory, cultures. The general examination should be performed systematically. Vital signs can be helpful, e.g., fever (usually…
Paroxysmal Sympathetic Hyperactivity in the Neurocritical Care Unit: Definition, Clinical Picture, Etiology, Diagnosis and Management
Figure 74.1. Minutely Heart Rate in an untreated dysautonomic subject (heart rates are minutely values derived from a 24 hour Holter monitor recording). With increasing time post injury, paroxysms decrease…
Monitoring Cerebral Blood Flow and Cerebral Autoregulation: Basic Principles, Techniques, Common Patterns and Interpretation of Results
Figure 9.1. Under physiological conditions, the brain maintains CBF within normal limits through autoregulation when the CPP is between 40 and 140 mmHg. Other factors that independently affect CBF are…
Intensive Care Management of Poor-grade SAH Patients. An Overview
Figure 73.1. An algorithm for decision-making in suspected vasospasm after SAH is provided. EVD = external ventricular drain; HC = hydrocephalus; ICH = intracerebral hemorrhage; IVH = intraventricular hemorrhage; MAP = mean arterial pressure. First choice of monitoring always includes…
Pathophysiology and Management of Cerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage
Figure 72.1 Management of cerebral vasospasm after aneurysmal subarachnoid hemorrhage. Columbia University Protocol. References 1. Suarez JI, Tarr RW, Selman WR. Aneurysmal subarachnoid hemorrhage. N Engl J Med 2006; 354:…
Ischemic Penumbra: Role of Neuroimaging in Treatment Decision
Figure 43.1. Schematic representation of the ischemic tissue after a major vessel occlusion. In black there is represented the ischemic core, irreversibly damaged. The ischemic penumbra is represented by the…
Optimizing Cerebral Perfusion Pressure in Acute Brain Injury
71 Optimizing Cerebral Perfusion Pressure in Acute Brain Injury Pedro Kurtz 1, Neeraj Badjatia 2 1 Neurological Intensive Care Unit, Department of Neurology, Columbia University Medical Center, New York, USA…
Stroke Units: Organization, Past, Present and Future
Figure 40.1. Stroke Code of The Madrid Stroke Network. Activation and distribution of stroke patients by the emergency coordination center. Infrastructure: Stroke Unit. Intensive Care Unit. Emergency Department. Stroke…
Medical Treatment of Severe Traumatic Brain Injury
Figure 34.1. Algorithm for the treatment of intracranial hypertension. HDB = Barbiturates in high doses; DC = Decompressive craniectomy; HV = Hyperventilation. Although we argue that the best approach would be personalized treatment of a patient’s…
Acute Hypertensive Response and Stroke
Figure 68.1. Algorithm for treatment of acute hypertensive response among patients with stroke and stroke subtypes. Based on the NINDS rtPA prethrombolytic protocol for patients with acute ischemic stroke, for…
