Neurological research
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Neurological research · Mar 2013
ReviewUltrasound-based imaging in neurocritical care patients: a review of clinical applications.
To analyze the diagnostic, monitoring, and procedural applications of ultrasound (US) imaging in neurocritical care (NCC) patients. ⋯ In conclusion, US imaging is an important diagnostic tool that provides real-time information at the bedside to stratify risk, monitor for complications, and guide invasive procedures in NCC patients.
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Neurological research · Mar 2013
ReviewRefractory status epilepticus: new insights in presentation, treatment, and outcome.
Refractory status epilepticus (RSE), defined as status epilepticus that fails to respond to the acute administration of two antiepileptic medications, occurs in approximately a third of patients with status epilepticus, and is associated with increased hospital length of stay, mortality, and functional disability. Common presentations include: (1) generalized convulsive status epilepticus or complex partial status epilepticus that continue despite initial therapies; (2) stupor or coma following a generalized convulsive or complex partial seizure; or (3) stupor or coma following brain surgery or acute brain injury. When status epilepticus continues or recurs 24 hours or more after the initiation of anesthetic therapy, or recurs on the reduction or withdrawal of anesthesia, it is termed super RSE. ⋯ Patients with cardiopulmonary complications and prolonged duration of drug-induced coma tend to have worse post-treatment functional outcomes. However, significant improvement over time can occur in survivors, and thus treatment is justified even in patients who require prolonged anesthetic coma. The strongest predictors of outcome are duration of anesthetic coma, etiology, and development of cardiopulmonary complications.
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Neurological research · Mar 2013
ReviewClinical course and treatment of vertebrobasilar dolichoectasia: a systematic review of the literature.
Vertebrobasilar dolichoectasia is a rare condition with unsettled clinical course and treatment. We performed a systematic review of the literature on clinical course and treatment of vertebrobasilar dolichoectasia. ⋯ Patients with vertebrobasilar dolichoectasia are at high risk of ischemic stroke, brainstem compression, and death. Hemorrhagic complications are less common. Risk of bias in the included studies was too high to make any recommendation regarding treatment.
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Neurological research · Mar 2013
Clinical relevance of negative initial angiogram in spontaneous subarachnoid hemorrhage.
We aimed to compare the presentation, management, and clinical course in patients with perimesencephalic and nonperimesencephalic (aneurysmal) bleeding patterns on noncontrast CT, but negative initial 4-vessel digital subtraction angiography (DSA). ⋯ In this series, perimesencephalic SAH was associated with good clinical grades, consistently negative initial and follow-up angiograms, and an excellent prognosis. In contrast, non-perimesencephalic SAH was associated with a worse clinical presentation, higher complication rates, higher rates of true aneurysm detection on follow-up angiogram, and a poorer outcome.
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Neurological research · Jan 2013
Persistence of secondary prevention medications after acute ischemic stroke or transient ischemic attack in Chinese population: data from China National Stroke Registry.
Although proven stroke secondary prevention medications are available, persistent use is required to be effective. The present study aimed to investigate the degree of secondary prevention medications persistence after acute ischemic stroke (AIS) or transient ischemic attack (TIA), factors influencing persistence and its association with stroke outcomes. ⋯ Almost one-third of patients of AIS/TIA had stopped one or more secondary prevention medications by 3-month postdischarge. Further studies on identifying potential barriers and means to improve persistent use of secondary prevention interventions are needed.