Journal of Neurocritical Care最新文献_第5页

Systolic blood pressure variability within 120 hours of admission predicts the functional outcomes at discharge of patients with acute ischemic stroke 入院120小时内收缩压变异性可预测急性缺血性卒中患者出院时的功能结局

Journal of Neurocritical Care Pub Date : 2022-04-19 DOI: 10.18700/jnc.210038

T. Pedro, Pedro Pereira, A. Costa, Fábio Almeida, M. Loureiro, T. Alfaiate, Abílio Gonçalves

{"title":"Systolic blood pressure variability within 120 hours of admission predicts the functional outcomes at discharge of patients with acute ischemic stroke","authors":"T. Pedro, Pedro Pereira, A. Costa, Fábio Almeida, M. Loureiro, T. Alfaiate, Abílio Gonçalves","doi":"10.18700/jnc.210038","DOIUrl":"https://doi.org/10.18700/jnc.210038","url":null,"abstract":"Background: Blood pressure variability (BPV) is a predictor of short- and long-term disability in patients with acute ischemic stroke (AIS). Its effect on more immediate functional outcomes has been seldom studied, and the results are inconsistent. We aimed to determine the role of BPV during the first 5 days of hospitalization in functional status at the time of discharge of patients with AIS. Methods: We enrolled 134 patients diagnosed with AIS and BPV using standard deviation and coefficient of variation (CV %). These were associated with the dichotomized modified Rankin Scale at discharge using logistic regression. Results: Patients with unfavorable outcomes were significantly older ( P =0.014), had a lower body mass index ( P =0.001), were less likely to present with dyslipidemia ( P =0.001), had lower serum triglyceride levels ( P =0.012), had a longer hospitalization period ( P <0.001), and had a higher mean National Institutes of Health Stroke Scale score at admission ( P <0.001). After adjusting for multiple confounders, the CV % of systolic blood pressure (SBP) in the first 120 hours after admission had a significant effect on functional disability at discharge. Conclusion: Variability in SBP in the first 5 days of hospitalization had a deleterious effect on the functional outcomes at discharge of patients with AIS. The role of diastolic BPV seems to be significant only in the first 24 hours of admission; however, further research is required.","PeriodicalId":33246,"journal":{"name":"Journal of Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44356663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Takotsubo syndrome and myasthenic crisis after radiocontrast media-induced anaphylaxis Takotsubo综合征与放射性造影剂致敏反应后的肌无力危象

Journal of Neurocritical Care Pub Date : 2022-03-23 DOI: 10.18700/jnc.210032

J. Cho, Hyeongsoo Kim, J. Yum

引用次数: 2

Recanalization of the middle cerebral artery after prolonged induced hypertensive therapy to rescue early neurologic deterioration 长期诱导性高血压治疗后大脑中动脉再分析挽救早期神经功能恶化

Journal of Neurocritical Care Pub Date : 2022-03-11 DOI: 10.18700/jnc.210036

Han Kyu Na, Taewon Kim, Jung-Yoon Yum, W. Park, Joonho Kim, Seok-joo Kim, Jong Hun Kim, K. Seo

引用次数: 0

A case of Brown-Sequard syndrome caused by spinal cord infarction 脊髓梗死所致褐sequard综合征1例

Journal of Neurocritical Care Pub Date : 2022-02-28 DOI: 10.18700/jnc.210041

S. Kim, Keun Lee, S. Sohn

{"title":"A case of Brown-Sequard syndrome caused by spinal cord infarction","authors":"S. Kim, Keun Lee, S. Sohn","doi":"10.18700/jnc.210041","DOIUrl":"https://doi.org/10.18700/jnc.210041","url":null,"abstract":"eral anterior or central cord lesions. However, unilateral hemicord lesions were rarely reported [1]. A 94-year-old woman visited our institution due to sudden right hemiplegia. Neurological examination findings were consistent with Brown-Sequard syndrome. The motor functions of the right arm and leg were given Medical Research Council scale grades of 1 and 2, respectively. Touch sensation was decreased in the right arm, trunk, and leg. Pain and temperature sensations were decreased on the left side. Magnetic resonance imaging showed diffusion restriction and T2-hyperintensity of the spinal cord between C2 and C5 level (Fig. 1). Cerebral angiography revealed a right vertebral artery occlusion (Fig. 2). The ischemia of separated anterior spinal arteries or sulco-commissural arteries can provoke partial Brown-Sequard syndrome [2]. However, under the above conditions, posterior spinal artery territories remain spared. The radiculomedullary arteries are branches of radicular arteries arising from the vertebral artery. They form a Y-shaped branch in the cervical region supplying both anterior and posterior spinal artery territories [3,4]. Ischemia of the unilateral radiculomedullary artery could provoke hemicord infarction [4]. In our case, occlusion of the right vertebral artery might have caused an ischemia A case of Brown-Sequard syndrome caused by spinal cord infarction","PeriodicalId":33246,"journal":{"name":"Journal of Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43697265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Utility of transoral and transcranial ultrasonography in the diagnosis of internal carotid dissection: a case report 经口及经颅超声在颈内动脉夹层诊断中的应用:1例报告

Journal of Neurocritical Care Pub Date : 2022-02-03 DOI: 10.18700/jnc.210033

Issac Cheong, Victoria Otero Castro, F. Tamagnone

引用次数: 2

Which one to do first?: a case report of simultaneous acute ischemic stroke and myocardial infarction 先做哪一个?急性缺血性脑卒中并发心肌梗死1例

Journal of Neurocritical Care Pub Date : 2021-12-29 DOI: 10.18700/jnc.210030

Kijeong Lee, W. Park, K. Seo, Hyeongsoo Kim

{"title":"Which one to do first?: a case report of simultaneous acute ischemic stroke and myocardial infarction","authors":"Kijeong Lee, W. Park, K. Seo, Hyeongsoo Kim","doi":"10.18700/jnc.210030","DOIUrl":"https://doi.org/10.18700/jnc.210030","url":null,"abstract":"Background: Although there are common risk factors for acute ischemic stroke and myocardial infarction, simultaneous onset of both diseases is uncommon. Here, we present a case of acute cerebral infarction with concurrent fatal myocardial infarction. Case Report: A 54-year-old man presented with left hemiparesis, gaze preponderance to the right side, and visual and tactile extinction. Computed tomography angiography showed occlusion of the right middle cerebral artery. ST-elevation myocardial infarction was suspected on electrocardiography. After the injection of intravenous tissue plasminogen activator, thrombectomy was attempted first, and the coronary angiogram was planned after recanalization of the cerebral artery. However, thrombectomy was discontinued because of cardiac arrest. Despite extracorporeal membrane oxygenation and emergency percutaneous coronary intervention, the patient died of multiorgan failure.Conclusion: Double primary acute ischemic stroke and myocardial infarction are rare but may be fatal due to the narrow therapeutic time window for both diseases. Careful consideration of the urgency of cardiac status is essential.","PeriodicalId":33246,"journal":{"name":"Journal of Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45714081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Neuroleptic malignant syndrome cases in a Moroccan intensive care unit: a retrospective analysis and literature review 摩洛哥重症监护病房的抗精神病药恶性综合征病例:回顾性分析和文献综述

Journal of Neurocritical Care Pub Date : 2021-12-29 DOI: 10.18700/jnc.210019

S. Touzani, Mohammed Hamdouni, Nawfal Houari, Youssef Yaakoubi Khbiza, A. Elbouazzaoui, B. Boukatta, N. Kanjaa

{"title":"Neuroleptic malignant syndrome cases in a Moroccan intensive care unit: a retrospective analysis and literature review","authors":"S. Touzani, Mohammed Hamdouni, Nawfal Houari, Youssef Yaakoubi Khbiza, A. Elbouazzaoui, B. Boukatta, N. Kanjaa","doi":"10.18700/jnc.210019","DOIUrl":"https://doi.org/10.18700/jnc.210019","url":null,"abstract":"Background: Neuroleptic malignant syndrome (NMS) is a rare but potentially life-threatening neuropsychiatric emergency. The aim of our study was to update our bedside procedures by investigating NMS cases managed in the intensive care unit (ICU).Methods: This retrospective study included all NMS patients admitted to our hospital between January 2012 and December 2019. The variables analyzed included demographics, diagnosis, therapeutics, and outcomes.Results: This study included 20 patients, with an average age of 36.6 years. The male to female ratio was 1:4. No patient had a history of NMS, and 60% of the patients had schizophrenia. First-generation neuroleptics (NLs) were the most commonly prescribed drugs (80%). The mean time between the introduction of NLs and onset of symptoms was 7.6 days. Rigidity was observed in 90% of the patients, hyperthermia and neuropsychic syndrome in 65%, and dysautonomia in 50%. The creatine phosphokinase level in all patients was four times the normal value. Mechanical ventilation was required in 20% of the patients and hemodialysis in one patient. None of the patients received specific therapy. The mean duration of ICU stay was 10 days. The mortality rate was 10%,, mainly associated with renal failure. The analysis of the predictors of mortality was limited by the size of our cohort.Conclusion: NMS is a rare condition requiring multidisciplinary implementation of contextualized and updated procedures. Early detection and supportive treatment could improve the prognosis in resource-limited settings, where specific treatments are not available. Predictive risk factors should be investigated in larger multicenter cohorts.","PeriodicalId":33246,"journal":{"name":"Journal of Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42616855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Posterior reversible encephalopathy syndrome as delayed neurological sequelae after carbon monoxide intoxication 一氧化碳中毒后迟发性神经后遗症的后可逆性脑病综合征

Journal of Neurocritical Care Pub Date : 2021-12-28 DOI: 10.18700/jnc.210027

H. Lee, Jin-Su Park

{"title":"Posterior reversible encephalopathy syndrome as delayed neurological sequelae after carbon monoxide intoxication","authors":"H. Lee, Jin-Su Park","doi":"10.18700/jnc.210027","DOIUrl":"https://doi.org/10.18700/jnc.210027","url":null,"abstract":"acute carbon monoxide (CO) poisoning. Neurological examinations were normal except for confusion. Initial brain images showed no acute lesions (Fig. 1A) on the next day of admission. Twelve days after CO intoxication, severe headache, choreic movement of both upper extremities, and impaired visual acuity with optic ataxia, oculomotor apraxia, and simultanagnosia were observed. Cerebrospinal fluid findings showed pleocytosis (white blood cell, 135/mm) with elevated protein level (134.8 mg/dL). From the follow-up brain magnetic resonance imaging, she was diagnosed with posterior reversible encephalopathy syndrome (PRES) as delayed neurologic sequelae (DNS) after CO intoxication (Fig. 1B). With steroid pulse therapy, she had clinical improvement (Fig. 1C). During the acute phase of CO poisoning, brain MRI shows signal changes in the bilateral globus pallidus (GP) with cytotoxic edema [1]. PRES shows distinctive MRI findings of the parieto-occipital lesions with either vasogenic or cytotoxic edema or both [2]. A patient with DNS with PRES was reported without GP involvement [3]. However, in this case, DNS after CO intoxication affected not only the basal ganglia but also the parieto-occipital regions as PRES. Therefore, it is the reason that the patient presented with both chorea and Balint’s syndrome simultaneously. ARTICLE INFORMATION","PeriodicalId":33246,"journal":{"name":"Journal of Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42860966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bilateral posterior cerebral artery stroke following transtentorial herniation caused by a subependymal giant cell astrocytoma in a patient with tuberous sclerosis: a case report 结节性硬化患者室管膜下巨细胞星形细胞瘤引起经幕疝后双侧大脑后动脉卒中1例

Journal of Neurocritical Care Pub Date : 2021-12-24 DOI: 10.18700/jnc.210034

Joong-Goo Kim, J. Choi, H. Kim, J. Rhim, T. Jung, C. Hyun, J. Joo

引用次数: 0

Supranuclear oculomotor palsy in cerebral venous sinus thrombosis: a case report 脑静脉窦血栓形成所致核上动眼性麻痹1例

Journal of Neurocritical Care Pub Date : 2021-12-24 DOI: 10.18700/jnc.210025

K. Bismaya, S. Pattanayak, A. Dixit, A. Pathak, R. Chaurasia, V. Singh

引用次数: 0