Journal of neurosurgical anesthesiology最新文献_第4页

A High Immediate Postoperative Systemic Immune-inflammation Index Is Associated With Postoperative Symptomatic Cerebral Infarction in Moyamoya Patients Undergoing Combined Revascularization Surgery. 接受联合血管重建手术的莫亚莫亚患者术后即刻全身免疫炎症指数高与术后症状性脑梗塞有关

IF 2.3 2区医学

Journal of neurosurgical anesthesiology Pub Date : 2025-04-01 Epub Date: 2024-05-29 DOI: 10.1097/ANA.0000000000000974

Na Young Kim, Kyung Won Shin, Woo-Young Jo, Hyongmin Oh, Sung Ho Lee, Won-Sang Cho, Jeong Eun Kim, Hee-Pyoung Park

{"title":"A High Immediate Postoperative Systemic Immune-inflammation Index Is Associated With Postoperative Symptomatic Cerebral Infarction in Moyamoya Patients Undergoing Combined Revascularization Surgery.","authors":"Na Young Kim, Kyung Won Shin, Woo-Young Jo, Hyongmin Oh, Sung Ho Lee, Won-Sang Cho, Jeong Eun Kim, Hee-Pyoung Park","doi":"10.1097/ANA.0000000000000974","DOIUrl":"10.1097/ANA.0000000000000974","url":null,"abstract":"Background: Inflammation plays a role in the pathogenesis of cerebral infarction. Postoperative symptomatic cerebral infarction (SCI) is a complication after revascularization surgery in patients with moyamoya disease (MMD). We investigated the association between the systemic-immune-inflammation index (SII) and postoperative SCI during hospital stay in such patients.Methods: Perioperative data were retrospectively obtained from 681 MMD patients who underwent revascularization surgery. SII cutoff values were identified as those where the sum of sensitivity and specificity associated with SCI were highest. Patients were divided into 4 subgroups according to the preoperative and immediate postoperative cutoff SII: HH (preoperative and postoperative SII high, n=22), LH (low preoperative and high postoperative SII, n=68), HL (high preoperative and low postoperative SII, n=125), and LL (preoperative and postoperative SII low, n=466).Results: Postoperative SCI occurred in 54 (7.6%) patients. The cutoff values for preoperative and immediate postoperative SII were 641.3 and 1925.4, respectively. Postoperative SCI during hospital stay was more frequent in the high postoperative SII group than in the low postoperative SII group (25.6% vs. 4.9%; P <0.001). Multivariate analysis revealed that a high immediate postoperative SII was a predictor of postoperative SCI (odds ratio, 11.61; 95% CI: 5.20-26.00; P <0.001). Postoperative SCI was lower in group LL than in group LH (3.6% vs. 23.5%, P <0.008) and was lower in group HL than in groups HH and LH (9.6% vs. 31.8% and 23.5%, both P <0.05).Conclusions: A high immediate postoperative SII was associated with postoperative SCI during hospital stay in MMD patients who underwent revascularization surgery.","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":"188-195"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Brain and Heart Interactions Delineating Cardiac Dysfunction in Four Common Neurological Disorders: A Systematic Review and Meta-analysis. 四种常见神经系统疾病中心功能障碍的脑与心相互作用：系统综述与元分析》。

IF 2.3 2区医学

Journal of neurosurgical anesthesiology Pub Date : 2025-04-01 Epub Date: 2024-08-22 DOI: 10.1097/ANA.0000000000000987

Amal Rezk, Winnie Liu, Kristof Nijs, Jun Won Lee, Wesley Rajaleelan, Rodrigo Nakatani, Emad Al Azazi, Marina Englesakis, Tumul Chowdhury

{"title":"Brain and Heart Interactions Delineating Cardiac Dysfunction in Four Common Neurological Disorders: A Systematic Review and Meta-analysis.","authors":"Amal Rezk, Winnie Liu, Kristof Nijs, Jun Won Lee, Wesley Rajaleelan, Rodrigo Nakatani, Emad Al Azazi, Marina Englesakis, Tumul Chowdhury","doi":"10.1097/ANA.0000000000000987","DOIUrl":"10.1097/ANA.0000000000000987","url":null,"abstract":"Neurological and cardiovascular disorders are the leading causes of morbidity and mortality worldwide. While the effects of cardiovascular disease (CD) on the nervous system are well understood, understanding of the reciprocal relationship has only recently become clearer. Based on disability-adjusted life years, this systematic review and meta-analysis present the pooled incidence and association of CD in 4 selected common, noncommunicable neurological disorders: (1) migraine, (2) Alzheimer disease and other dementias, (3) epilepsy, and (4) head injury. Sixty-five studies, including over 4 and a half million patients, were identified for inclusion in this review. Among the 4 neurological disorders, the majority of patients (89.4%) had epilepsy, 9.6% had migraine, and 0.97% had head injury. Alzheimer disease and other dementias were reported in only 0.02% of patients. The pooled effect estimates (incidence and association) of CD in the 4 neurological disorders was 10% (95% CI: 5.8%-16.9%; I2 = 99.94%). When stratified by the neurological disorder, head injury was associated with the highest incidence of CD (28%). The 4 neurological disorders were associated with a 2-fold increased odds for developing CD in comparison to patients without neurological disorders. Epilepsy was associated with the greatest increased odds of developing CD (odds ratio: 2.25; 95% CI: 1.82-2.79; P = 0.04). In studies that reported this variable, the pooled hazard ratio was 1.64 (95% CI: 1.38-1.94), with head injury having the highest hazard ratio (2.17; 95% CI: 1.30-3.61). Large prospective database studies are required to understand the long-term consequences of CD in patients with neurological disorders.","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":"156-165"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142017713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Updates to Journal of Neurosurgical Anesthesiology Editorial Board. 《神经外科麻醉学杂志》编辑委员会更新。

IF 2.3 2区医学

Journal of neurosurgical anesthesiology Pub Date : 2025-04-01 Epub Date: 2025-03-03 DOI: 10.1097/ANA.0000000000001028

引用次数: 0

Individualized, Autoregulatory-guided Intracranial Pressure and Cerebral Perfusion Pressure Targets in Severe Cerebral Venous Thrombosis: Preliminary Findings. 重度脑静脉血栓形成个体化、自我调节引导的颅内压和脑灌注压靶点：初步发现。

IF 2.3 2区医学

Journal of neurosurgical anesthesiology Pub Date : 2025-03-25 DOI: 10.1097/ANA.0000000000001034

Olle Hejdenberg, Anders Hånell, Anders Lewén, Per Enblad, Teodor Svedung Wettervik

{"title":"Individualized, Autoregulatory-guided Intracranial Pressure and Cerebral Perfusion Pressure Targets in Severe Cerebral Venous Thrombosis: Preliminary Findings.","authors":"Olle Hejdenberg, Anders Hånell, Anders Lewén, Per Enblad, Teodor Svedung Wettervik","doi":"10.1097/ANA.0000000000001034","DOIUrl":"https://doi.org/10.1097/ANA.0000000000001034","url":null,"abstract":"Background: Severe cerebral venous thrombosis (CVT) patients often require neurointensive care with multimodal monitoring. However, optimal treatment targets for intracranial pressure (ICP), cerebral perfusion pressure (CPP), and cerebral autoregulation remain unclear. This study investigated the relationships between ICP, CPP, and autoregulation indices (PRx, optimal CPP [CPPopt]) with clinical outcomes in severe CVT.Methods: This observational study included 15 patients with severe CVT with ICP-monitoring, treated in the neurointensive care (NIC) unit, Uppsala. The percentage of eligible monitoring time (EMT) outside certain thresholds was calculated for ICP, PRx, CPP, and ΔCPPopt (CPP-CPPopt) and analysed in relation to outcome (Glasgow Outcome at Discharge Scale [GODS]). Outcome heatmaps were generated to visualize transitions from better to worse outcomes for single variables and 2 variables (ICP, CPP, or ΔCPPopt in combination with PRx).Results: Median %EMT for ICP>20 mm Hg and CPP<60 mm Hg was <5%. Higher %EMT for ICP>20 mm Hg (r=-0.60, P=0.02) correlated with worse outcome (lower GODS). The median %EMT of impaired cerebral pressure autoregulation was 34%. Outcome heatmaps indicated transitions toward worse outcome when PRx exceeded zero and ΔCPPopt became negative, but these correlations were not significant. Higher PRx reduced the safe ICP and CPP range, in 2-variable heatmaps.Conclusions: A higher %EMT of ICP>20 mm Hg was unfavorable in severe CVT. Impaired cerebral autoregulation with high PRx was frequent and may reduce the safe ICP/CPP range. Larger, multi-centre studies are needed to validate these findings in this rare condition.","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Quality Improvement Project to Reduce the Incidence of Prolonged Preoperative Fasting in Patients Undergoing Elective Neurosurgical Procedures, the NEURO-FAST Study. 一项旨在减少选择性神经外科手术患者术前长时间禁食发生率的质量改进项目，即neurofast研究。

IF 2.3 2区医学

Journal of neurosurgical anesthesiology Pub Date : 2025-02-10 DOI: 10.1097/ANA.0000000000001030

Keta Thakkar, Lallu Joseph, Reka Karuppusami, Priscilla Rachel Meganathan, Deborah Snegalatha, Georgene Singh

引用次数: 0

Safety and Efficacy of Neuroprotective Agents as Adjunctive Therapies for Reperfusion in the Treatment of Acute Ischemic Stroke: A Systematic Review and Meta-analysis of Randomized Controlled Trials. 神经保护剂作为再灌注辅助疗法治疗急性缺血性卒中的安全性和有效性：随机对照试验的系统评价和荟萃分析。

IF 2.3 2区医学

Journal of neurosurgical anesthesiology Pub Date : 2025-02-06 DOI: 10.1097/ANA.0000000000001029

Zihui Zhang, Xinyan Wang, Kangda Zhang, Youxuan Wu, Fa Liang, Anxin Wang, Ruquan Han

{"title":"Safety and Efficacy of Neuroprotective Agents as Adjunctive Therapies for Reperfusion in the Treatment of Acute Ischemic Stroke: A Systematic Review and Meta-analysis of Randomized Controlled Trials.","authors":"Zihui Zhang, Xinyan Wang, Kangda Zhang, Youxuan Wu, Fa Liang, Anxin Wang, Ruquan Han","doi":"10.1097/ANA.0000000000001029","DOIUrl":"https://doi.org/10.1097/ANA.0000000000001029","url":null,"abstract":"There is still no clear evidence of the efficacy of the application of neuroprotective agents (NPAs) for acute ischemic stroke (AIS) patients receiving reperfusion therapies. This meta-analysis aimed to determine the effects of NPAs versus placebo on functional and safety outcomes as an adjunctive treatment to intravenous thrombolysis (IVT) or endovascular therapy (EVT) in AIS patients. The primary outcome was neurological functional independence, as evaluated by the proportion of patients whose modified Rankin Scale scores were 0 to 2 at 90 days after treatment. Thirteen randomized controlled trials with a total of 3736 patients were included. The application of NPAs was associated with greater odds of functional independence (odds ratio [OR]: 1.28; 95% CI: 1.12 to 1.46; P < 0.001; I2 = 0.0%) within 90 days. However, subgroup analysis of reperfusion therapy type (IVT, EVT, or both) revealed that only the EVT subgroup showed a significant association between NPAs or placebo and functional independence at 90 days (EVT group, OR: 1.43; 95% CI: 1.05 to 1.94; P = 0.022; I2 = 0.0%; IVT group, OR: 1.51; 95% CI: 0.93 to 2.46; P = 0.099; I2 = 39.8%; IVT plus EVT group, OR: 1.17; 95% CI: 0.94 to 1.45; P = 0.157; I2 = 16.0%). This meta-analysis revealed that NPAs could increase the possibility of AIS patients undergoing reperfusion therapies achieving functional independence within 90 days of onset; however, with the limited number of studies on each drug, further evidence is still needed to demonstrate the efficacy of each individual agent as an adjunctive therapy for different means of reperfusion.","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Epidemiology of Post-craniotomy Hypertension and Its Association With Adverse Outcome(s): A Systematic Review and Meta-analysis. 开颅术后高血压的流行病学及其与不良后果的关系：一项系统综述和荟萃分析。

IF 2.3 2区医学

Journal of neurosurgical anesthesiology Pub Date : 2025-01-14 DOI: 10.1097/ANA.0000000000001025

Abramo Aziz Rizk, Kristof Nijs, Anne T Di Donato, Nahemah Hasanaly, Naeema S Masohood, Tumul Chowdhury

{"title":"Epidemiology of Post-craniotomy Hypertension and Its Association With Adverse Outcome(s): A Systematic Review and Meta-analysis.","authors":"Abramo Aziz Rizk, Kristof Nijs, Anne T Di Donato, Nahemah Hasanaly, Naeema S Masohood, Tumul Chowdhury","doi":"10.1097/ANA.0000000000001025","DOIUrl":"https://doi.org/10.1097/ANA.0000000000001025","url":null,"abstract":"After intracranial surgery, sympathetic overdrive and increased blood catecholamine levels can contribute to postoperative hypertension, a significant clinical problem. The objective of this review was to summarize, quantify, and assess the epidemiological perspective of post-craniotomy hypertension and its association with adverse outcomes. This PROSPERO-registered systematic review was conducted following PRISMA guidelines. We searched electronic databases for studies that investigated adult patients who had elective craniotomy for any indication and reported hypertension within 72 hours postoperatively. Study quality was assessed using the Newcastle-Ottawa scale. Twenty-one studies, including 2602 patients, were identified for inclusion in this review. Multiple thresholds and criteria for defining post-craniotomy hypertension were used across studies. The pooled incidence of post-craniotomy hypertension from 13 studies (2279 patients) was 30% [95% CI, 15%-50%]. Post-craniotomy hypertension was associated with a 2.6 times higher risk of having an intracerebral hemorrhage within 72 hours after surgery (pooled risk ratio, 2.63; 95% CI, 1.16-5.97). There were insufficient data to investigate the quantitative association of post-craniotomy hypertension with 30-day adverse events. In summary, 1 out of 3 patients exhibited hypertension post-craniotomy, and this was associated with a significantly higher risk of having intracranial hemorrhage within 72 hours post-procedure. A generally accepted and clinically relevant criteria for post-craniotomy hypertension should be defined.","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142978972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effects of Scalp Nerve Block on Symptomatic Cerebral Hyperperfusion Syndrome After Combined Revascularization Surgery for Moyamoya Disease. 头皮神经阻滞对烟雾病联合血运重建术后症状性脑高灌注综合征的影响。

IF 2.3 2区医学

Journal of neurosurgical anesthesiology Pub Date : 2025-01-13 DOI: 10.1097/ANA.0000000000001024

Seungeun Choi, Jung Yeon Park, Woo-Young Jo, Kyung Won Shin, Hee-Pyoung Park, Sung Ho Lee, Won-Sang Cho, Jeong Eun Kim, Hyongmin Oh

{"title":"Effects of Scalp Nerve Block on Symptomatic Cerebral Hyperperfusion Syndrome After Combined Revascularization Surgery for Moyamoya Disease.","authors":"Seungeun Choi, Jung Yeon Park, Woo-Young Jo, Kyung Won Shin, Hee-Pyoung Park, Sung Ho Lee, Won-Sang Cho, Jeong Eun Kim, Hyongmin Oh","doi":"10.1097/ANA.0000000000001024","DOIUrl":"https://doi.org/10.1097/ANA.0000000000001024","url":null,"abstract":"Background: Strict blood pressure control can be used to prevent or treat cerebral hyperperfusion syndrome. This study investigated whether scalp nerve block (SNB) is associated with a reduced risk of postoperative symptomatic cerebral hyperperfusion syndrome (SCHS) by reducing postoperative blood pressure in adult patients who underwent combined revascularization surgery for moyamoya disease.Methods: Patients were retrospectively divided into the SNB (n=167) and control (n=221) groups depending on whether SNB was performed immediately before placement of wound dressings at the end of surgery. Postoperative SCHS was defined as new-onset postoperative neurological deficits with a focal increase in cerebral blood flow at the perianastomosis site in the absence of infarction or hemorrhage on postoperative brain imaging. Inverse probability of treatment weighting was used to balance preoperative variables between the 2 groups.Results: The incidence of postoperative SCHS did not differ between the SNB and control groups (61 [36.5%] vs. 102 [46.2%], P=0.072), but its duration was shorter in the SNB group (4 [2-6] vs. 5 [3-7] days, P=0.021). Although of limited clinical relevance, the SNB group had lower postoperative pain scores and systolic blood pressures at postoperative days 0 to 1 and a shorter intensive care unit stay.Conclusions: Despite some potential benefits, SNB was not associated with a reduced incidence of postoperative SCHS in adult patients who underwent combined revascularization surgery for moyamoya disease.","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparison of Intubating Conditions Between Direct Laryngoscopy and C-MAC Video-laryngoscopy in Patients With Simulated Cervical Spine Immobilization: A Systematic Review and Meta-analysis. 模拟颈椎固定患者直接喉镜和C-MAC视频喉镜插管条件的比较：系统回顾和meta分析。

IF 2.3 2区医学

Journal of neurosurgical anesthesiology Pub Date : 2025-01-10 DOI: 10.1097/ANA.0000000000001023

Sharmishtha Pathak, Niraj Kumar, Aanchal Purohit, Ashish Bindra, Anjishnujit Bandyopadhyay

{"title":"Comparison of Intubating Conditions Between Direct Laryngoscopy and C-MAC Video-laryngoscopy in Patients With Simulated Cervical Spine Immobilization: A Systematic Review and Meta-analysis.","authors":"Sharmishtha Pathak, Niraj Kumar, Aanchal Purohit, Ashish Bindra, Anjishnujit Bandyopadhyay","doi":"10.1097/ANA.0000000000001023","DOIUrl":"https://doi.org/10.1097/ANA.0000000000001023","url":null,"abstract":"Intubation of patients requiring cervical spine immobilization can be challenging. Recently, the use of C-MAC video laryngoscopes (VL) has increased in popularity over direct laryngoscopy (DL). We aimed to conduct a systematic review and meta-analysis to evaluate the efficacy of C-MAC VL as compared with DL for intubation in C-spine immobilized patients. A systematic search of electronic databases, including PubMed, Cochrane Library, Embase, and Web of Science was performed. Time taken to intubate was the primary outcome whereas the use of optimization maneuvers, laryngoscopy view, first-pass success rates, and difficulty of intubation were secondary outcomes. Seven trials involving 490 patients were included in the analysis. There was no significant difference between the 2 groups in terms of time taken to intubate, standardized mean difference 0.65 (95% CI, -2.55, 3.86). The certainty of evidence for the primary outcome, time taken to intubate, was low, with high heterogeneity (I2=97%). The C-MAC VL group had higher first-pass success rates (odds ratio 2.92 [95% CI, 1.14, 7.49]) and a lower incidence of a poor laryngoscopy view (odds ratio 0.21 [95% CI, 0.07, 0.66]). There was no difference in terms of the difficulty of intubation and the use of optimization maneuvers. Overall, C-MAC VL did not reduce the time taken to intubate, although the strength of this finding is limited by wide confidence intervals. C-MAC VL significantly improved laryngoscopy views and first-pass success rate as compared with DL.","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Role of Processed Electroencephalography in the Detection and Management of Acute Cerebral Ischemia: A Scoping Review. 处理脑电图在急性脑缺血检测和治疗中的作用：范围综述。

IF 2.3 2区医学

Journal of neurosurgical anesthesiology Pub Date : 2025-01-09 DOI: 10.1097/ANA.0000000000001018

David W Hewson, Alex Mankoo, Philip M Bath, Mark Barley, Permesh Dhillon, Luqman Malik, Kailash Krishnan

{"title":"The Role of Processed Electroencephalography in the Detection and Management of Acute Cerebral Ischemia: A Scoping Review.","authors":"David W Hewson, Alex Mankoo, Philip M Bath, Mark Barley, Permesh Dhillon, Luqman Malik, Kailash Krishnan","doi":"10.1097/ANA.0000000000001018","DOIUrl":"https://doi.org/10.1097/ANA.0000000000001018","url":null,"abstract":"Processed electroencephalography (pEEG) is increasingly used to titrate the depth of anesthesia. Whether such intra-procedural pEEG monitoring can offer additional information on cerebral perfusion or acute focal or global cerebral ischemia is unknown. This scoping review aimed to provide a narrative analysis of the current literature reporting the potential role of pEEG in adults with acute cerebral ischemia. In keeping with the scoping review methodology, a broad search strategy was defined, including descriptions of encephalography in acute ischemic stroke, carotid endarterectomy, cardiac surgery, and cardiac arrest. Additional screening of citations was conducted by 2 independent assessors. From 310 records, 28 full-text articles met inclusion criteria. Most identified studies were observational in design, and described the diagnostic ability of pEEG to identify cerebral hypoperfusion or its prognostic sensitivity after stroke or carotid surgery. No studies were identified that evaluated pEEG in the specific setting of endovascular therapy for acute ischemic stroke. Low sensitivity associations between pEEG indices and cerebral blood flow were highlighted, which may be influenced by cerebral autoregulatory thresholds. Despite the associations reported in observational studies, this review identified significant uncertainty in the role of pEEG during cerebral ischemia. There is a paucity of high-level observational (cohort or case-control) or randomized trial research examining the possible role of pEEG for the detection and management of cerebral ischemia during acute stroke, including during endovascular therapy, or in other common scenarios of acute cerebral ischemia.","PeriodicalId":16550,"journal":{"name":"Journal of neurosurgical anesthesiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0