Neurocritical care
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Case Reports
Plastic in the Brain: Delayed Recognition of Progressive Unilateral Hemispheric Lesions.
Flow diverters are increasingly used to treat complex ruptured intracranial aneurysms. Most complications are ischemic and seen early after placement. ⋯ Polymer embolization associated with a flow diverter may cause fluctuating unilateral hemisheric lesions and become symptomatic. Inflammatory response to a foreign body (polymer strands) can be succesfully treated with corticosteroids.
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Outcome predictions in patients with acute severe neurologic disorders are difficult and influenced by multiple factors. Since the decision for and the extent of life-sustaining therapies are based on the estimated prognosis, it is vital to understand which factors influence such estimates. This study examined whether previous professional experience with rehabilitation medicine influences physician decision-making. ⋯ Our results indicate that there are subjective factors influencing decisions to limit life-sustaining treatments that are based on previous professional experience. This finding emphasizes the variability and cognitive bias of such decision processes and should be integrated into future guidelines for specialist training on end-of-life decision-making.