Neurocritical care
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Editorial Comment
Intervascular Line Infections: Can We Prevent Them? Bring on the Team!
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Spinal cord injury (SCI) is present in around 2-4% of trauma victims. More than half of this injuries are located at the cervical region. Twenty percent of victims with cervical spinal trauma and 5% of patients with severe traumatic brain injury (TBI) will have an SCI. Cervical immobilization with rigid or semirigid collars is routinely used as prophylactic or definitive treatment intervention in general trauma care. An important adverse effect of cervical collars application is the increase in intracranial pressure (ICP) values. This systematic review and meta-analysis aim to estimate the overall magnitude of ICP changes after cervical collar application. ⋯ Heterogeneous studies of application of cervical collars as a partial motion restriction strategy after injuries have demonstrated increases in ICP in TBI patients. Increases in ICP can induce complications in TBI patients. Appropriate selection criteria for cervical motion restriction in TBI patients need to be considered.
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The aim of this study was to evaluate the impact of radiographic cerebral small vessel disease (CSVD) on the severity of acute intracerebral hemorrhage (ICH) as measured by: ICH volume, hematoma expansion, and extension of intraventricular hemorrhage (IVH). ⋯ Leukoaraiosis and cerebral atrophy appear to have opposing associations with ICH severity. Cerebral atrophy correlates with smaller ICH volume and decreased risk and severity of IVH, while leukoaraiosis is associated with increased risk of IVH. Whether these observations reflect overlapping or divergent underlying mechanisms requires further study.