Article
Clinical Neurology
Gustavo Chagoya, Arsalaan Salehani, B. Ethan Tabibian, Nicholas M. B. Laskay, Brandon M. Fox, Nidal B. Omar, Bart Thaci, Joshua D. Bernstock, Galal A. Elsayed, Mark R. Harrigan
Summary: This case demonstrates that enlargement and rupture of an incidental, previously unruptured aneurysm may occur during hyperdynamic therapy.
WORLD NEUROSURGERY
(2021)
Article
Clinical Neurology
Dorothee Mielke, Katja Doering, Daniel Behme, Marios Nikos Psychogios, Veit Rohde, Vesna Malinova
Summary: The study aimed to assess the impact of endovascular rescue therapies on the long-term functional outcome of patients with refractory cerebral vasospasm following aneurysmal subarachnoid hemorrhage.
FRONTIERS IN NEUROLOGY
(2022)
Article
Clinical Neurology
E. Francois Aldrich, Randall Higashida, Abdel Hmissi, Elizabeth J. Le, R. Loch Macdonald, Angelina Marr, Stephan A. Mayer, Sebastien Roux, Nicolas Bruder
Summary: Aneurysmal subarachnoid hemorrhage (aSAH) is associated with significant morbidity and mortality. The presence of thick, diffuse subarachnoid blood may indicate a worse clinical course and outcome, independently of other known prognostic factors. Patients with thick and diffuse SAH have higher rates of mortality, vasospasm-related morbidity, and poor clinical outcomes compared to those without thick and diffuse SAH.
JOURNAL OF NEUROSURGERY
(2021)
Article
Clinical Neurology
Manuel Angermann, Fidaa Jablawi, Maike Angermann, Catharina Conzen-Dilger, Gerrit A. Schubert, Anke Hollig, Michael Veldeman, Arno Reich, Dimah Hasan, Hani Ridwan, Hans Clusmann, Martin Wiesmann, Omid Nikoubashman
Summary: The objective of this study was to compare the clinical outcomes of patients with nonperimesencephalic subarachnoid hemorrhage (npSAH) with those of patients with aneurysmal SAH (aSAH) and perimesencephalic SAH (pSAH), and to evaluate the predictive value of various clinical and radiological findings in npSAH patients. The results showed that npSAH patients had similar clinical outcomes as aSAH patients, but with significantly fewer clinical complications. pSAH patients had a favorable clinical course. The initial Hunt and Hess score emerged as an important predictor of clinical outcome in both aSAH and npSAH.
WORLD NEUROSURGERY
(2022)
Article
Clinical Neurology
S. Andersen, E. Western, W. Sorteberg, A. Sorteberg
Summary: Pre-ictal and continued use of statins in aSAH patients may reduce the occurrence of cerebral vasospasm, shorten hospital stay, and lead to more favorable functional outcomes, while mortality rates remain similar to those who do not use statins. Larger multicenter studies are needed to further establish the benefits of statins in aSAH.
ACTA NEUROCHIRURGICA
(2023)
Article
Clinical Neurology
Hans-Jakob Steiger, Rolf Ensner, Lukas Andereggen, Luca Remonda, Jatta Berberat, Serge Marbacher
Summary: The study aims to investigate the cerebral hemodynamic effects and outcome of intravenous milrinone plus norepinephrine supplemented by intra-arterial nimodipine as a rescue strategy for delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (SAH). The results show that this rescue strategy significantly improves cerebral perfusion and may benefit patients in the long term.
ACTA NEUROCHIRURGICA
(2022)
Article
Medicine, General & Internal
Johannes Walter, Martin Grutza, Markus Moehlenbruch, Dominik Vollherbst, Lidia Vogt, Andreas Unterberg, Klaus Zweckberger
Summary: The effect of intraarterial administration of nimodipine on functional and neuropsychological outcomes after delayed vasospasm following aSAH was evaluated in this study. The results showed that patients treated with intraarterial nimodipine achieved similar functional and neuropsychological outcomes as conservatively treated patients at medium- and long-term follow-up, suggesting a potential beneficial effect of this treatment for delayed vasospasm after aSAH.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Medicine, General & Internal
In-Suk Bae, Hyoung-Joon Chun, Kyu-Sun Choi, Hyeong-Joong Yi
Summary: The study proposed a new scoring system, the GCS-F score, combining GCS and mFS, for predicting outcomes and vasospasm occurrence in aSAH patients, which was more detailed than other single scales.
Review
Clinical Neurology
Mojtaba Dayyani, Behnam Sadeghirad, James C. Grotta, Samira Zabihyan, Saba Ahmadvand, Yuting Wang, Gordon H. Guyatt, Sepideh Amin-Hanjani
Summary: Network meta-analysis showed that nimodipine and cilostazol were likely the most effective treatments in preventing morbidity and mortality in patients with aneurysmal subarachnoid hemorrhage. Clazosentan, nicardipine, fasudil, and magnesium showed beneficial effects on delayed cerebral ischemia and vasospasm but they were not found to reduce mortality or disability.
Review
Clinical Neurology
Sandeep Mishra, Kanwaljeet Garg, Vishwa Bharathi Gaonkar, Preet Mohinder Singh, Manmohan Singh, Ashish Suri, P. Sarat Chandra, Shashank Sharad Kale
Summary: This network meta-analysis compared various therapeutic agents for their effects on functional outcome and other parameters after aneurysmal subarachnoid hemorrhage (aSAH). The results suggest that nicardipine prolonged-release implants and cilostazol may be the best options for improving favorable outcomes and reducing mortality in patients with aSAH.
WORLD NEUROSURGERY
(2021)
Review
Clinical Neurology
Guangzhi Hao, Guangxin Chu, Pengyu Pan, Yuwei Han, Yunzheng Ai, Zuolin Shi, Guobiao Liang
Summary: Nimodipine can significantly reduce poor outcome, mortality, and cerebral vasospasm in patients with aneurysmal subarachnoid hemorrhage (aSAH), with a stronger effect observed in patients younger than 50 years old.
FRONTIERS IN NEUROLOGY
(2022)
Review
Clinical Neurology
Adam Beighley, Ryan Glynn, Tyler Scullen, Mansour Mathkour, Cassidy Werner, John F. Berry, Christopher Carr, Hussam Abou-Al-Shaar, Aimee Aysenne, John D. Nerva, Aaron S. Dumont
Summary: Aneurysmal subarachnoid hemorrhage (aSAH) during pregnancy requires early transfer to a specialized facility with neurocritical care, high-risk obstetric service, and neurosurgery team for management. Intensive monitoring and a multidisciplinary approach are essential to ensure maternal and fetal health.
NEUROSURGICAL REVIEW
(2021)
Article
Clinical Neurology
S. Tsutsui, T. Matsuda, K. Takeda, M. Sasaki, Y. Kubo, K. Setta, S. Fujiwara, K. Chida, K. Ogasawara
Summary: This study aimed to quantitatively assess temperature increases on various types of titanium alloy aneurysm clips during 7T MR imaging. Results showed temperature increases varied among different types of clips, with some exceeding regulatory limits.
AMERICAN JOURNAL OF NEURORADIOLOGY
(2022)
Article
Medicine, General & Internal
Helena Merkel, Dirk Lindner, Khaled Gaber, Svitlana Ziganshyna, Jennifer Jentzsch, Simone Mucha, Thilo Gerhards, Sabine Sari, Annika Stock, Felicitas Vothel, Lea Falter, Ulf Quaeschling, Karl-Titus Hoffmann, Juergen Meixensberger, Dirk Halama, Cindy Richter
Summary: This study proposes a visual classification scheme for cerebral vasospasm that is suitable for endovascular treatment. The results show good agreement between mathematical clustering and physician scoring. Additionally, the study finds that a threshold-based criterion does not provide additional advantages, and automated vessel analysis is superior in research settings.
JOURNAL OF CLINICAL MEDICINE
(2022)
Review
Clinical Neurology
Michael Ortiz, Ravi S. Nunna, Kaushik Ravipati, Angela Tran, Adnan Qureshi, Farhan Siddiq
Summary: Dantrolene shows promise as a therapeutic agent for cerebral vasospasm, with potential for both intra-arterial and intravenous administration, but uncertainties remain regarding dosage and safety. Limited clinical data suggest efficacy in treating cerebral vasospasm, but the level of evidence is low, requiring further high-quality studies.
WORLD NEUROSURGERY
(2022)
Article
Critical Care Medicine
Melissa Wagner, Krista Lim-Hing, Mary Ann Bautista, Brigid Blaber, Taghi Ryder, Joseph Haymore, Neeraj Badjatia
Summary: The study demonstrates that continuous noninvasive temperature monitoring is a suitable alternative method for assessing core temperature during TTM. The results show good agreement between the superficial temperature monitor and core temperature measures in all patients overall.
NEUROCRITICAL CARE
(2021)
Article
Critical Care Medicine
Neeraj Badjatia, Nidhi Gupta, Stephanie Sanchez, Joseph Haymore, Hemantkumar Tripathi, Rushil Shah, Casey Hannan, Harikrishna Tandri
Summary: This study tested the safety and feasibility of a novel transnasal evaporative cooling device for inducing and maintaining normothermia in febrile stroke patients. Results showed 90% of patients achieved normothermia without significant adverse events or shivering. A multicenter trial testing the device's ability to maintain normothermia for 24 hours is currently underway.
NEUROCRITICAL CARE
(2021)
Review
Pharmacology & Pharmacy
Melissa Pergakis, Neeraj Badjatia, J. Marc Simard
Summary: Cerebral edema is a common and important complication of various neurological diseases, and further research is needed to study the safety and efficacy of drugs in treatment. IV glibenclamide has shown potential in the treatment of cerebral edema, but consideration of the underlying pathophysiology and pharmacodynamics of the disease is crucial.
EXPERT OPINION ON PHARMACOTHERAPY
(2021)
Article
Critical Care Medicine
Christopher Melinosky, Hope Kincaid, Jan Claassen, Gunjan Parikh, Neeraj Badjatia, Nicholas A. Morris
Summary: The study assessed the interrater reliability of the mFS in 46 neurointensivists, finding moderate agreement among raters. Online training tools are needed to improve mFS reliability and standardize research in SAH.
NEUROCRITICAL CARE
(2021)
Article
Medicine, General & Internal
Benjamin L. Brett, Mark D. Kramer, John Whyte, Michael A. McCrea, Murray B. Stein, Joseph T. Giacino, Mark Sherer, Amy J. Markowitz, Geoffrey T. Manley, Lindsay D. Nelson
Summary: This study identified four distinct neurobehavioral phenotypes in patients with TBI two weeks after injury, which significantly improved estimation of association with 6-month outcomes when added to demographic characteristics and other injury characteristics in models. These distinct phenotypes may assist in clinical decision-making and patient selection for clinical trials.
Article
Medicine, General & Internal
Harvey S. Levin, Nancy R. Temkin, Jason Barber, Lindsay D. Nelson, Claudia Robertson, Jeffrey Brennan, Murray B. Stein, John K. Yue, Joseph T. Giacino, Michael A. McCrea, Ramon Diaz-Arrastia, Pratik Mukherjee, David O. Okonkwo, Kim Boase, Amy J. Markowitz, Yelena Bodien, Sabrina Taylor, Mary J. Vassar, Geoffrey T. Manley
Summary: This study identified that women are more susceptible than men to persistent mTBI-related cognitive and somatic symptoms, with no sex differences observed after orthopedic injury. Post-concussion symptoms were also more severe in women aged 35 to 49 than in younger and older women.
Article
Clinical Neurology
Aparna Vadlamani Chauhan, Jack Guralnik, Susan dosReis, John D. Sorkin, Neeraj Badjatia, Jennifer S. Albrecht
Summary: This study aimed to determine the incidence and risk factors for repetitive traumatic brain injury (TBI) among older adults in the United States. It found that epilepsy was the strongest predictor of repetitive TBI, followed by Alzheimer disease and related dementias. Future work should focus on reducing the risk of repetitive TBI and assessing related outcomes.
JOURNAL OF HEAD TRAUMA REHABILITATION
(2022)
Article
Critical Care Medicine
Murad Megjhani, Kalijah Terilli, Lakshman Kalasapudi, Justine Chen, John Carlson, Serenity Miller, Neeraj Badjatia, Peter Hu, Angela Velazquez, David J. Roh, Sachin Agarwal, Jan Claassen, E. S. Connolly, Xiao Hu, Nicholas Morris, Soojin Park
Summary: The study developed an automatic method to predict the onset of ventriculitis by analyzing intracranial pressure waveform morphology. The results showed that intracranial pressure waveform morphology analysis can classify ventriculitis without cerebrospinal fluid sampling.
NEUROCRITICAL CARE
(2022)
Article
Critical Care Medicine
Matthew N. Jaffa, Ruchira M. Jha, Jonathan Elmer, Adam Kardon, Jamie E. Podell, Benjamin E. Zusman, Madeleine C. Smith, J. Marc Simard, Gunjan Y. Parikh, Michael J. Armahizer, Neeraj Badjatia, Nicholas A. Morris
Summary: This study identified five distinct pain trajectories following SAH, with groups 3 and 5 showing higher risk for continued opioid use at follow-up. Additionally, a history of depression and belonging to a racial/ethnic minority were also associated with prolonged opioid use.
NEUROCRITICAL CARE
(2021)
Article
Critical Care Medicine
Brittany Bolduc Lachance, WanTsu Chang, Melissa Motta, Gunjan Parikh, Jamie Podell, Neeraj Badjatia, J. Marc Simard, Gary T. Schwartzbauer, Nicholas A. Morris
Summary: This study retrospectively reviewed six cases of refractory intracranial hypertension and found that verticalization intervention can effectively reduce ICP, decrease ICP spikes, and lower the percentage of ICP values greater than 20 mmHg.
NEUROCRITICAL CARE
(2022)
Article
Clinical Neurology
Esther L. Yuh, Sonia Jain, Xiaoying Sun, Dana Pisica, Mark H. Harris, Sabrina R. Taylor, Amy J. Markowitz, Pratik Mukherjee, Jan Verheyden, Joseph T. Giacino, Harvey S. Levin, Michael McCrea, Murray B. Stein, Nancy R. Temkin, Ramon Diaz-Arrastia, Claudia S. Robertson, Hester F. Lingsma, David O. Okonkwo, Andrew I. R. Maas, Geoffrey T. Manley
Summary: Pathological CT features after mild traumatic brain injury (mTBI) were found to have different prognostic implications, with some patterns of injury associated with worse outcomes than others. This study supports the need for TBI-specific education and systematic follow-up for patients with mTBI and specific CT features.
Article
Critical Care Medicine
Neeraj Badjatia, Joseph Haymore, Marc E. Voorhees, Kevin Goundry, Corey Lewis, Gabriella Judd, Stephanie Sanchez
Summary: This study demonstrates that resting energy expenditure (REE) can be accurately estimated using heat transfer data from a surface gel pad temperature modulating device (TMD) and clinical characteristics of patients. Factors associated with REE include patient age, sex, body surface area, temperature, and heat transfer.
THERAPEUTIC HYPOTHERMIA AND TEMPERATURE MANAGEMENT
(2022)
Review
Critical Care Medicine
Jamie Podell, Melissa Pergakis, Shiming Yang, Ryan Felix, Gunjan Parikh, Hegang Chen, Lujie Chen, Catriona Miller, Peter Hu, Neeraj Badjatia
Summary: Subtle and profound changes in autonomic nervous system function occur in critical illness, particularly in neurocritical illness, and can be measured quantitatively at the bedside. Data analytics can identify physiological changes that precede clinical detection of meaningful events, providing a window for time-sensitive therapies. This review discusses data-analytic approaches to measuring autonomic nervous system dysfunction and their potential for early detection and monitoring.
NEUROCRITICAL CARE
(2022)
Article
Critical Care Medicine
Shannon Arnold, Michael Armahizer, Luis F. Torres, Hemant Tripathi, Harikrishna Tandri, Jason J. Chang, H. Alex Choi, Neeraj Badjatia
Summary: This study compared a novel transnasal temperature-modulating device (tnTMD) with surface cooling temperature-modulating devices (sTMDs) in achieving and maintaining normothermia in mechanically ventilated febrile neurocritical care patients. The results showed that the tnTMD approach achieved similar time to normothermia and temperature burden with less shivering compared to the sTMD approach. This suggests that transnasal cooling could be a feasible option for this patient population.
NEUROCRITICAL CARE
(2023)
Article
Clinical Neurology
Matthew N. Jaffa, Jamie E. Podell, Madeleine C. Smith, Arshom Foroutan, Adam Kardon, Wan-Tsu W. Chang, Melissa Motta, Gunjan Y. Parikh, Kevin N. Sheth, Neeraj Badjatia, Michael J. Armahizer, J. Marc Simard, Nicholas A. Morris
Summary: The study found that continued opioid use following aneurysmal subarachnoid hemorrhage (aSAH) is common and related to pain burden during acute illness, but not to the opioid dose during hospitalization. New analgesic strategies are needed to reduce continued opioid use in these patients.