Neurocritical care
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South America is a subcontinent with 393 million inhabitants with widely distinct countries and diverse ethnicities, cultures, political and societal organizations. The epidemiological transition that accompanied the technological and demographic evolution is happening in South America and leading to a rise in the incidence of neurodegenerative and cardiovascular diseases that now coexist with the still high burden of infectious diseases. ⋯ In this article, we discuss the existing systems of care in different countries of South America for the treatment of neurological emergencies, mainly stroke, status epilepticus, and traumatic brain injury. We also will address existing gaps between the current systems and recommendations from the literature to improve the management of such emergencies, as well as strategies on how to solve these disparities.
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The aim of the study is to investigate the value of serum iron and hemoglobin levels for predicting acute seizures following aneurysmal subarachnoid hemorrhage (aSAH). ⋯ Serum iron and hemoglobin levels were inversely associated with a high risk of acute seizures following aSAH.
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Case Reports
Leaking the Diagnosis: A Case of Convulsive Status Epilepticus Due to Intracranial Hypotension.
We describe a case of convulsive status epilepticus caused by intracranial hypotension, a complication of spinal surgery. Intracranial hypotension (IH) is typically characterized by an orthostatic headache. There have been limited case reports describing surgery-associated IH presenting with seizures. ⋯ IH is an under-recognized cause of seizure following the spinal or cranial surgery, lumbar puncture, or spinal anesthesia. Proposed mechanisms include traction on cortical structures, increased cerebral blood flow, and cortical irritation secondary to subdural hygromas.
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Editorial Comment
Is Post-Neurointensive Care Syndrome Actually a Thing?