Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Oct 2021
Observational StudyPhysiological Signatures of Brain Death Uncovered by Intracranial Multimodal Neuromonitoring.
The physiological and neurochemical changes that accompany brain death are not well described. ⋯ A characteristic set of changes in cerebrovascular physiology and neurochemistry occurs during brain death. These changes can be identified by intracranial neuromonitoring.
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J Neurosurg Anesthesiol · Jul 2021
Anesthesia During Positive-pressure Myelogram: A New Role for Cerebral Oximetry.
Positive-pressure myelogram (PPM) is an emerging radiologic study used to localize spinal dural defects. During PPM, cerebrospinal fluid pressure (CSFp) is increased by injecting saline with contrast into the cerebrospinal fluid. This has the potential to increase intracranial pressure and compromise cerebral perfusion. ⋯ Systemic blood pressure increased following intrathecal injection during PPM, possibly due to a physiologic response to intracranial hypertension/reduced cerebral perfusion or administration of phenylephrine. Regional cerebral oxygen saturation decreased with the change to prone position and further decreased upon intrathecal injection. Cerebral near-infrared spectroscopy has a potential role to monitor the adequacy of cerebral perfusion and guide adjustment of systemic blood pressure during PPM.
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J Neurosurg Anesthesiol · Jul 2021
Observational StudyIschemia-modified Albumin as a Biomarker for Prediction of Poor Outcome in Patients With Traumatic Brain Injury: An Observational Cohort Study.
Biomarkers can assist in outcome prediction and therapeutic decision making after traumatic brain injury (TBI). The aim of this study was to evaluate the role of ischemia-modified albumin (IMA) in the prediction of mortality in patients with TBI. ⋯ IMA levels were elevated in patients following TBI, and can predict mortality with high sensitivity and specificity.