Neurology

Neurology

Managing Intracranial Pressure Crisis

Abstract: Viarasilpa provides a comprehensive review of current strategies for managing intracranial pressure (ICP) crises, emphasizing critical care management, ICP monitoring, neuromonitoring, and evidence-based therapeutic approaches. The review integrates protocols from the Brain Trauma Foundation (BTF), Seattle International Severe Traumatic Brain Injury Consensus Conference (SIBICC), and Consensus-based management protocol (CREVICE), advocating personalized, neuromonitoring-driven interventions to […]

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Neurology

The promise of transcranial focused ultrasound in disorders of consciousness: a narrative review

Abstract Transcranial focused ultrasound (tFUS) has emerged as a promising non-invasive neuromodulation technique for disorders of consciousness (DOC). This work critically evaluates tFUS’s potential, highlighting its unique ability to precisely modulate deep brain structures, particularly the thalamus, while maintaining non-invasiveness. The mechanisms of action span multiple levels, from membrane-level ion channel modulation to network-wide changes

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Neurology

Mastering the brain in critical conditions: an update

Abstract Acute brain injuries, such as traumatic brain injury and ischemic and hemorragic stroke, are a leading cause of death and disability worldwide. While characterized by clearly distict primary events—vascular damage in strokes and biomechanical damage in traumatic brain injuries—they share common secondary injury mechanisms influencing long-term outcomes. Growing evidence suggests that a more personalized

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Neurology

Use of Hypertonic Saline in Neuroanesthesia and Neurocritical Care Practice: A Narrative Review

Abstract Hypertonic saline (HTS) is a group of fluids containing sodium and chloride in a higher concentration as compared to physiological saline. The authors have conducted this review to evaluate the use of HTS in neuroanesthesia and neurocritical care. The articles for this narrative review on HTS were searched on databases like PubMed Central, EMBASE,

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Neurology

Treatment-Related Reversible Cerebral Vasoconstriction Syndrome

Abstract Reversible cerebral vasoconstriction syndrome (RCVS) is a rare but significant cause of intracranial arteriopathy and stroke in young adults. The syndrome encompasses a spectrum of disorders radiologically characterized by reversible narrowing and dilation of intracranial arteries, often triggered by vasoactive drugs or the postpartum period. The hallmark clinical feature of RCVS is thunderclap headache

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Neurology

Metabolomic in severe traumatic brain injury: exploring primary, secondary injuries, diagnosis, and severity

Abstract Background Traumatic brain injury (TBI) is a major public health concern worldwide, contributing to high rates of injury-related death and disability. Severe traumatic brain injury (sTBI), although it accounts for only 10% of all TBI cases, results in a mortality rate of 30–40% and a significant burden of disability in those that survive. This

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Neurology

Quality improvement in the determination of death by neurologic criteria around the world

Abstract This article discusses global variations in policies and practices for determining death by neurologic criteria (DNC). It highlights efforts to improve standardization and accuracy, emphasizing the importance of adhering to the World Brain Death Project (WBDP) guidelines. The paper also reviews confounders, complications, and special considerations for pediatric patients in DNC determination. Key Points

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Neurology

Neuromodulation in the intensive care unit

Neuromodulation, through various forms of invasive and noninvasive stimulations at the central or peripheral level, can enhance or suppress neural activities, offering the potential for therapeutic intervention. Studies of neuromodulation have reported intriguing clinical outcomes and promising application prospects across various disciplines, particularly in the realm of novel therapeutic modalities. Critically ill patients are commonly

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Neurology

Feasibility Study of Endoscopic Surgery for Spontaneous Intracerebral Hemorrhage with Large Hematoma: a Comparison with Craniotomy Using Propensity Score Matching Analysis

Abstract Background Spontaneous intracerebral hemorrhage (ICH) with large hematomas is commonly treated with craniotomy combined with decompressive craniectomy, procedures that involve huge trauma and require subsequent cranioplasty. Recently, endoscopic surgery has shown significant promise in treating ICH, but its feasibility for large hematomas remains uncertain. Therefore, this study aims to compare endoscopic surgery with craniotomy

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Feasibility Study of Endoscopic Surgery for Spontaneous Intracerebral Hemorrhage with Large Hematoma: a Comparison with Craniotomy Using Propensity Score Matching Analysis Read Post »

Neurology

The Pupillary Light-Off Reflex in Acute Disorders of Consciousness

Abstract Background In intensive care patients with disorders of consciousness, the pupillary light reflex is a measure of pupillary parasympathetic function. By contrast, the pupillary light-off reflex leads to pupil dilation in response to an abrupt change from light to darkness (“light-off”) and reflects combined parasympathetic and sympathetic pupillary function. To our knowledge, this reflex

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