Neurocritical care
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Calculating the risk benefit equation for aggressive treatment of non-convulsive status epilepticus.
To address the question: does non-convulsive status epilepticus warrant the same aggressive treatment as convulsive status epilepticus? ⋯ Determination of the optimal management approach to non-convulsive status epilepticus is complex and is ultimately determined by the inciting etiology.
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Red blood cell (RBC) transfusion after aneurysmal subarachnoid hemorrhage (aSAH) has been associated with increased mortality but prior studies have not adequately adjusted for transfusion-indication bias. ⋯ Among patients with aSAH, RBC transfusion was independently associated with an increased mortality after adjustment for the most common clinical indications for transfusion.
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Acute amnesia can be caused by medication effect, transient global amnesia, ischemia, metabolic abnormalities, and seizures. ⋯ Ischemia in the posterior circulation should be considered in the differential diagnosis of TGA, especially in situations predisposing to thromboembolism such as coiling.
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Comparative Study
Mild prolonged hypothermia for large intracerebral hemorrhage.
Perihemorrhagic edema (PHE) develops after intracerebral hemorrhage (ICH). It can worsen the clinical situation by its additional mass effect. Therapeutic hypothermia (TH) might be an effective method to control PHE, but has not been sufficiently studied in ICH patients. ⋯ These data support the promising results of our first case series on TH in large ICH. TH prevents the development of PHE and its complications. Side effects of TH appeared often, but could be treated sufficiently. Therefore, TH might represent a new therapy for PHE after large ICH, but has to be further tested in randomized trials.