Neurocritical care
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Hypoxic-ischemic brain injury is a common cause of mortality after cardiac arrest (CA) and cardiopulmonary resuscitation; however, the specific underlying mechanisms are unclear. This study aimed to explore postresuscitation changes based on multi-omics profiling. ⋯ Our results provided novel insight into the mechanism of hypoxic-ischemic brain injury after resuscitation, which is envisaged to help identify potential diagnostic and therapeutic markers.
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Gerstmann syndrome, characterized by a tetrad of symptoms, which are agraphia, acalculia, left-right disorientation, and finger agnosia, presents challenges in both understanding its pathophysiology and establishing effective treatment modalities. Neuroanatomical studies have highlighted the involvement of the dominant parietal lobe, particularly the inferior parietal lobule, in the development of Gerstmann syndrome. ⋯ However, clinical evidence supporting DBS in Gerstmann syndrome remains scarce, posing challenges in patient selection and ethical considerations. Future research should prioritize investigating the efficacy and safety of DBS in Gerstmann syndrome to improve patient outcomes and quality of life.
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Review Meta Analysis
Machine Learning Algorithms to Predict Delayed Cerebral Ischemia After Subarachnoid Hemorrhage: A Systematic Review and Meta-analysis.
Delayed cerebral ischemia (DCI) is a common and severe complication after subarachnoid hemorrhage (SAH). Logistic regression (LR) is the primary method to predict DCI, but it has low accuracy. This study assessed whether other machine learning (ML) models can predict DCI after SAH more accurately than conventional LR. ⋯ For ML models, the pooled sensitivity was 0.74 (95% CI 0.61-0.86; p < 0.01) and the pooled specificity was 0.78 (95% CI 0.71-0.86; p = 0.02). Our results suggest that ML algorithms performed better than conventional LR at predicting DCI. Trial Registration: PROSPERO (International Prospective Register of Systematic Reviews) CRD42023441586; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=441586.
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The limited representation from developing countries in the original COME TOGETHER survey gave us an impetus to conduct this survey in the Indian subcontinent. ⋯ Differences from the global survey were noted regarding the following: traumatic brain injury being the most common etiology of coma in India, more frequent practice of sedation interruption, less frequent use of electroencephalography in India, rare use of pharmacological neurostimulants, and home being the most common discharge disposition in India.
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The use of multimodal neuromonitoring in pediatrics is in its infancy relative to adult neurocritical care. Multimodal neuromonitoring encompasses the amalgamation of information from multiple individual neuromonitoring devices to gain a more comprehensive understanding of the condition of the brain. It allows for adaptation to the changing state of the brain throughout various stages of injury with potential to individualize and optimize therapies. ⋯ The possible benefits of multimodal neuromonitoring are immense and have great potential to advance the field of pediatric neurocritical care and the health of critically ill children.