Journal of Neurocritical Care最新文献_第8页

Primary central nervous system lymphoma with intramedullary spinal cord involvement mimicking inflammatory demyelinating disease 原发性中枢神经系统淋巴瘤伴髓内脊髓受累模拟炎症性脱髓鞘疾病

Journal of Neurocritical Care Pub Date : 2019-06-26 DOI: 10.18700/JNC.190083

Hyunsoo Kim, T. Nam, M. Levy, Kyung-Hwa Lee, Jahae Kim, Seung Jin Lee

引用次数: 0

Cerebrovascular complications during pregnancy and postpartum 妊娠期和产后脑血管并发症

Journal of Neurocritical Care Pub Date : 2019-06-25 DOI: 10.18700/JNC.190087

Jeong‐Ho Hong

引用次数: 1

Clinical and neuroimaging determinants of minimally conscious and persistent vegetative states after acute stroke 急性脑卒中后最低意识和持续性植物人状态的临床和神经影像学决定因素

Journal of Neurocritical Care Pub Date : 2019-06-19 DOI: 10.18700/JNC.190080

E. Kumral, F. Bayam, Bedriye Köken, C. Erdoğan

{"title":"Clinical and neuroimaging determinants of minimally conscious and persistent vegetative states after acute stroke","authors":"E. Kumral, F. Bayam, Bedriye Köken, C. Erdoğan","doi":"10.18700/JNC.190080","DOIUrl":"https://doi.org/10.18700/JNC.190080","url":null,"abstract":"Background: Patients with persistent vegetative state (PVS) show no evidence of awareness of self or their environment, and those with minimally conscious state (MCS) have severely impaired consciousness with minimal but definite behavioral evidence of self or environmental awareness after stroke. Neuroimaging and clinical characteristics separating these two close consciousness states after stroke were insufficiently studied. Methods: We conducted a hospital-based cohort study of all patients with stroke (2011 to 2017) who underwent 3T magnetic resonance imaging and consciousness assessment after 3 months of inclusion. Univariate and multivariate regression analyses were used to estimate the relative risk of neuroimaging markers for differentiation of PVS and MCS. Results: Of 3,600 eligible subjects, 323 patients (0.09%) had PVS and 93 (0.02%) had MCS (mean age, 62.25±13.4 years). Higher stroke volume was strongly associated with PVS compared to MCS (odds ratio [OR], 0.99; 95% confidence interval [CI], 0.98 to 1.00; P=0.001). On univariate analysis, cingulate gyrus (OR, 2.7; 95% CI, 1.62 to 4.36; P=0.001) and corpus callosum (OR, 2.1; 95% CI, 1.28 to 3.44; P=0.003) involvement was significantly associated with PVS. However, on multivariate analysis, only cingulate gyrus involvement was independently associated with PVS (OR, 2.2; 95% CI, 1.33 to 3.72; P=0.002). Conclusion: Our results indicate that PVS and MCS are different consciousness states according to clinical and neuroimaging findings. To predict outcome, cognitive performance of these patients should be well questioned after stroke.","PeriodicalId":33246,"journal":{"name":"Journal of Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44041133","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: 2

Generalized periodic discharges with triphasic morphology 具有三相形态的广义周期放电

Journal of Neurocritical Care Pub Date : 2019-06-19 DOI: 10.18700/JNC.190079

J. Hartshorn, B. Foreman

{"title":"Generalized periodic discharges with triphasic morphology","authors":"J. Hartshorn, B. Foreman","doi":"10.18700/JNC.190079","DOIUrl":"https://doi.org/10.18700/JNC.190079","url":null,"abstract":"Generalized periodic discharges (GPDs) are electroencephalographic (EEG) waveforms that can be seen in a wide array of encephalopathies. By definition, they are repeated and generalized waveforms with relatively uniform morphology and duration, with a quantifiable interdischarge interval between consecutive waveforms, and recurrence of the waveform at nearly regular intervals (Fig. 1) [1]. There are different theories for their etiology and pathophysiology. Early work suggested that GPDs were due to widespread cortical destruction with relative sparing of white Generalized periodic discharges (GPDs) with triphasic morphology are an electroencephalographic (EEG) pattern traditionally associated with encephalopathy and coma, although they have been observed in a wide array of neurological disorders. The clinical significance of these waveforms and their relationship to seizures and prognosis has been debated, and differentiation between interictal patterns, patterns associated with seizures, and patterns representing nonconvulsive status epilepticus can at times be a challenge. The most established literature suggests that GPDs, including those with triphasic morphology, are associated with the development of electrographic seizures, but that in the absence of clinical information, distinguishing waveforms based on morphology alone may not be clinically useful. Recent work has advocated for a more proactive approach in evaluating GPDs with triphasic morphology. Further studies of nonsedating antiseizure drugs in patients with GPDs with triphasic morphology that incorporate continuous EEG monitoring will be useful in tailoring therapy to optimize long-term clinical outcomes and recovery.","PeriodicalId":33246,"journal":{"name":"Journal of Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44426349","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: 7

Cerebral air embolism treated using hyperbaric oxygen therapy 高压氧治疗脑空气栓塞

Journal of Neurocritical Care Pub Date : 2019-06-19 DOI: 10.18700/JNC.190085

Yeon-Jung Kim, Sang-beom Jeon

{"title":"Cerebral air embolism treated using hyperbaric oxygen therapy","authors":"Yeon-Jung Kim, Sang-beom Jeon","doi":"10.18700/JNC.190085","DOIUrl":"https://doi.org/10.18700/JNC.190085","url":null,"abstract":"A 59-year-old man underwent endoscopic balloon dilation for esophageal stricture. Upon the completion of the procedure, he was observed to be stuporous and quadriplegic. Computed tomography (CT) of the brain revealed multiple air emboli (Fig. 1A). Magnetic resonance imaging (MRI) performed 45 minutes after symptom onset revealed multiple lesions showing signal loss on susceptibility-weighted imaging, high signal intensity on diffusion-weighted imaging, and diffuse enhancement on T1-weighted contrast-enhanced imaging, which were compatible with air emboli, hyperacute infarcts, and a disrupted bloodbrain barrier, respectively (Fig. 1B-1D). Hyperbaric oxygen therapy (HBOT) was administered 80 minutes after MRI (targeting 3.0 atmospheric pressure for 2 hours). Follow-up CT performed 80 minutes after HBOT revealed disappearance of the air emboli (Fig. 1E). Follow-up MRI performed 5 days after HBOT also revealed a decrease in the resolution of previously documented findings (Fig. 1F-1H). Most of his neurological symptoms improved, except mild left hemiparesis. This case indicates that MRI is a useful modality in diagnosing cerebral air embolism by documenting air emboli, hyperacute infarcts, and disruption of the blood–brain barrier [1-3]. HBOT may accelerate the disappearance of air emboli and proIMAGES IN NEUROCRITICAL CARE","PeriodicalId":33246,"journal":{"name":"Journal of Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49569660","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: 2

Status epilepticus due to cerebral air embolism after the Valsalva maneuver 瓦尔萨尔瓦术后大脑空气栓塞致癫痫持续状态

Journal of Neurocritical Care Pub Date : 2019-06-19 DOI: 10.18700/JNC.190075

H. Lyou, Hye-Jeong Lee, G. Lee, Won-Joo Kim

引用次数: 1

Recurrent aseptic meningitis as an initial clinical presentation of primary Sjögren’s syndrome 复发性无菌性脑膜炎作为原发性Sjögren综合征的初始临床表现

Journal of Neurocritical Care Pub Date : 2019-05-31 DOI: 10.18700/JNC.190077

D. H. Lee, S. Lee

引用次数: 1

Primary neurocritical care involving therapeutic hypothermia for acute ischemic stroke patients with malignant infarct cores 急性缺血性脑卒中伴恶性梗死患者的初级神经危重症护理包括治疗性低温治疗

Journal of Neurocritical Care Pub Date : 2019-05-30 DOI: 10.18700/JNC.190076

Seong-Joon Lee, Kyu Sun Lee, J. S. Lee, M. H. Choi, S. E. Lee, Ji-Hee Hong

引用次数: 4

Feasibility, Safety, and Follow-up Angiographic Results of Endovascular Treatment for Non-Selected Ruptured Intracranial Aneurysms Under Local Anesthesia with Conscious Sedation 清醒镇静局部麻醉下血管内治疗非选择性破裂颅内动脉瘤的可行性、安全性和随访血管造影结果

Journal of Neurocritical Care Pub Date : 2018-12-27 DOI: 10.18700/JNC.180059

Jongsoo Kang, Chul-Hoo Kang, J. Roh, J. Yeom, D. Shim, Youngsoo Kim, Sang Won Lee, Young-Soo Kim, K. Park, Chang-Hun Kim, Soo-Kyoung Kim, Nack-Cheon Choi, O. Kwon, H. Kang, S. Baik

引用次数: 1

Nutritional Support for Neurocritically Ill Patients 神经危重症患者的营养支持

Journal of Neurocritical Care Pub Date : 2018-12-27 DOI: 10.18700/JNC.180070

H. Jeong, Soo-Hyun Park, H. Ryu

{"title":"Nutritional Support for Neurocritically Ill Patients","authors":"H. Jeong, Soo-Hyun Park, H. Ryu","doi":"10.18700/JNC.180070","DOIUrl":"https://doi.org/10.18700/JNC.180070","url":null,"abstract":"Nutritional assessment and support are often overlooked in the critically ill due to other urgent priorities. Unlike oxygenation, organ dysfunction, infection, or consciousness, there is no consensus of indicators. Making it difficult to evaluate the effectiveness of an intervention. Nevertheless, appropriate nutritional support in the critically ill has been associated with less morbidity and lower mortality. But, nutritional support has been considered an adjunct, for body weight maintenance and to help patients during the inflammatory phase of illness. Thus, it has been assigned a lower priority, compared to mechanical ventilation or hemodynamic stability. Recent findings have shown that nutritional support may prevent cellular injury due to oxidative stress and help strengthen the immune response. Largescale randomized trials and clinical guidelines have shown a shift from nutritional support to nutritional therapy, with an emphasis on the importance of protein, minerals, vitamins, and trace elements. Nutrition is also important in neurocritically ill patients. Since there are few studies or recommendations with regard to the neurocritical population, the general recommendations for nutritional support should be applied.","PeriodicalId":33246,"journal":{"name":"Journal of Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46569396","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