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Record Nr. |
UNINA9910865292103321 |
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Autore |
Prabhakar Hemanshu |
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Titolo |
Principles and Practice of Neurocritical Care |
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Pubbl/distr/stampa |
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Singapore : , : Springer, , 2024 |
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©2024 |
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ISBN |
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Edizione |
[1st ed.] |
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Descrizione fisica |
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1 online resource (839 pages) |
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Altri autori (Persone) |
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SinghalVasudha |
ZirpeKapil G |
SapraHarsh |
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Disciplina |
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Lingua di pubblicazione |
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Formato |
Materiale a stampa |
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Livello bibliografico |
Monografia |
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Nota di contenuto |
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Intro -- Preface -- Acknowledgments -- Contents -- Part I: History of Neurocritical Care -- 1: Introduction to Neurocritical Care -- References -- Part II: Basic Principles of Neurocritical Care -- 2: Neurological Examination in Neurocritical Care -- 2.1 Introduction -- 2.2 The ABCDE (Airway, Breathing, Circulation, Disability, Exposure) Approach and the ABCGS (Airway, Breathing, Circulation, Glucose, or Seizures) Approach -- 2.2.1 Initial Assessment -- 2.2.2 History and General Examination -- 2.2.3 Neurological Examination of a Conscious Patient -- Neurological Examination of a Patient with an Altered Sensorium -- 2.2.4 Neurological Examination of a Patient in a Coma -- 2.3 Examination of Cranial Nerves (CNs) [5, 11] -- 2.3.1 Motor Functions and Assessment -- 2.3.2 Reflex Examination -- Upper Motor vs. Lower Motor Neuron Disease -- 2.3.3 Motor Examination in an Unconscious Patient -- 2.3.4 Sensory Testing -- 2.3.5 Pupillary Size and Reflex -- 2.3.6 Brainstem Reflexes -- 2.3.7 Neuroexamination in Pediatrics -- References -- 3: Cerebrospinal Fluid Dynamics -- 3.1 Introduction -- 3.2 CSF-Containing Spaces [4] -- 3.3 CSF Production -- 3.3.1 From the Choroid Plexus (CP) -- The Role of Ion Channels in CSF Secretion from the CP -- Ion Transport -- 3.3.2 Extra-Choroidal CSF Formation -- Movement of Glucose -- Movement of Proteins -- 3.4 CSF |
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Composition -- 3.5 Continuity between the Ventricular CSF and the Brain ECS -- 3.6 The Role of the Glymphatic System -- 3.7 CSF Flow -- 3.8 CSF Reabsorption -- 3.8.1 Meningeal Lymphatics -- 3.8.2 Continuous Fluid Exchange [13] -- 3.9 CSF Dynamics and ICP Elevation -- 3.10 Hydrocephalus -- 3.11 Idiopathic Intracranial Hypertension (IIH) -- 3.12 Traumatic Brain Injury -- 3.13 Intracerebral Hemorrhage -- 3.14 Subarachnoid Hemorrhage -- 3.15 Ischemic Stroke [13] -- 3.16 Conclusions. |
References -- 4: Cerebral Hemodynamics -- 4.1 Introduction -- 4.1.1 Special Needs of the Brain -- 4.1.2 Unique Features of Cerebral Circulation -- 4.1.3 Determinants of Cerebral Blood Flow -- 4.2 Regulation of Cerebral Blood Flow -- 4.2.1 Regulation of Cerebral Blood Flow Can Be Divided into Four Categories (Fig. 4.4) -- 4.3 Alterations of Cerebral Blood Flow Regulation in Health and Disease -- 4.3.1 Effect of Aging -- 4.3.2 Effect of Posture -- 4.3.3 Effect of Exercise -- 4.3.4 Effect of Hypertension -- 4.3.5 Effect of Stroke -- 4.3.6 Effect of Anesthesia -- References -- Part III: Monitoring in Neurocritical Care -- 5: Intracranial Pressure Monitoring -- 5.1 Introduction -- 5.2 ICP Waveform: Physiological and Pathological Trends -- 5.3 Intracranial Pressure-Volume Relationship: Intracranial Compliance -- 5.4 ICP Interplay with Cerebral Perfusion Pressure (CPP) -- 5.5 ICP Measurement -- 5.5.1 Historical Perspective -- 5.5.2 Current Practice -- 5.5.3 Invasive ICP Monitoring -- 5.5.4 Noninvasive Techniques -- 5.6 Future Avenues for ICP Monitoring -- References -- 6: Cerebral Blood Flow Monitoring -- 6.1 Introduction -- 6.2 Arterial Supply of the Brain -- 6.3 The Physiological Aspects of Cerebral Blood Flow -- 6.3.1 Cerebral Physiology and CBF -- 6.3.2 Factors Affecting CBF [9] -- Intrinsic Factors -- Extrinsic Factors Affecting CBF -- 6.3.3 Cerebral Autoregulation (CA) -- 6.4 Cerebral Blood Flow Monitoring -- 6.4.1 General Concepts -- Fick's Principle -- The Central Volume Principle [37] -- Doppler Effect and Intensity Fluctuations [37] -- 6.4.2 Cerebral Blood Flow Monitoring Techniques -- Direct Techniques -- 6.4.3 Imaging-Based CBF Techniques -- X-Ray-Based Techniques -- MRI-Based Techniques -- Ultrasonography (USG)-Based Techniques -- 6.4.4 Optical Techniques -- 6.4.5 Nuclear Medicine-Based Techniques. |
6.4.6 Monitoring Cerebral Autoregulation -- 6.4.7 Newer Advances -- Microwave-Based CBF Analysis -- Ultrasound-Tagged (UT)-NIRS -- 6.5 Conclusion -- References -- 7: Jugular Venous Oximetry -- 7.1 Introduction -- 7.2 History -- 7.3 Relevant Anatomy -- 7.4 Site of Monitoring -- 7.5 Insertion of a Jugular Bulb Catheter -- 7.6 Avoidance of Extracranial Contamination -- 7.7 Intermittent and Continuous Monitoring -- 7.8 Complications -- 7.9 The Fundamental Concepts of Jugular Venous Oximetry -- 7.10 Clinical Applications of SjVO2 -- 7.10.1 Traumatic Brain Injury -- 7.10.2 Subarachnoid Hemorrhage -- 7.10.3 Cardiac Surgeries -- 7.10.4 Neuroprognostication after Cardiac Arrest -- 7.10.5 Effect of Anesthetics on SjVO2 -- 7.11 Limitations -- 7.12 Conclusions -- References -- 8: EEG for the Intensivist: Basics -- 8.1 Introduction -- 8.2 Basics of EEG -- 8.3 Important Terminology -- 8.4 Various Patterns Seen in EEG -- 8.4.1 Normal Adult EEG -- 8.5 Pattern 3: Periodic Epileptiform Discharges (PEDs) -- 8.5.1 Periodic Lateralized Epileptiform Discharges or Lateralized Periodic Discharges -- 8.5.2 Bilateral Independent Periodic Lateralized Epileptiform Discharges -- 8.5.3 Generalized Periodic Discharges -- 8.5.4 Stimulus-Induced Periodic, Rhythmic, or Ictal Discharges (SIRPIDs) -- 8.5.5 Triphasic Waves -- 8.6 Pattern 4: Burst-Suppression Pattern (BSP) -- 8.7 Pattern 5: Electrographic Seizures -- 8.7.1 Focal Electrographic Seizures -- |
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8.7.2 Generalized Electrographic Seizures -- 8.8 Continuous EEG -- References -- 9: Transcranial Doppler -- 9.1 Introduction -- 9.2 Physical Principle -- 9.3 Transcranial Doppler (TCD) Versus Transcranial Color-Coded Duplex Sonography (TCCD) -- 9.4 Technique of TCD -- 9.5 Spectral Waveform Analysis -- 9.6 TCD Indices -- 9.7 Assessment of Cerebral Hemodynamics by TCD -- 9.8 Clinical Uses. |
9.9 Limitations of TCD -- 9.10 Summary -- References -- 10: Evoked Response Monitoring -- 10.1 Introduction -- 10.2 Applied Anatomy -- 10.3 Basics of Recording -- 10.3.1 Montages -- 10.3.2 Nearfield and Far-Field Potentials [3, 5] -- 10.3.3 Nomenclature, Amplitude, and Latency -- 10.4 Recording Technique -- 10.4.1 Upper Limb -- 10.4.2 Lower Limb -- 10.5 Interpretation -- 10.6 Prolongation of Latency -- 10.7 Changes in Amplitude -- 10.8 Absence of Waves -- 10.8.1 Upper Limb (Table 10.3) -- 10.8.2 Lower Limb (Table 10.4) -- 10.9 Factors Affecting SSEPs -- 10.10 Indications and Common Applications in Critical Care -- 10.10.1 Prognostication After Cardiac Arrest [12-18] -- 10.10.2 Prognostication After Traumatic Brain Injury [1, 19-21] -- 10.11 Other Uses -- 10.12 Multimodal Monitoring [23, 24] -- 10.13 Other Evoked Responses in Critical Care [25] -- References -- 11: Near Infrared Spectroscopy -- 11.1 Introduction -- 11.2 Factors Affecting NIRS-Based Cerebral Oximetry Readings -- 11.3 Clinical Application of NIRS-Based Cerebral Oximetry in NICU -- References -- 12: Brain Tissue Oxygenation -- 12.1 Introduction: The Physiology of Brain Oxygen -- 12.1.1 Systemic Determinants of Brain Oxygen -- 12.1.2 Arterial Oxygen Content -- 12.1.3 Cerebral Blood Flow -- 12.1.4 Capillary Oxygen Delivery -- 12.1.5 Oxygen Diffusion -- 12.2 Brain Tissue Oxygen Monitoring -- 12.2.1 Normal Values for Brain Oxygen Levels -- 12.3 Methodological Issues with Clinical Monitoring of pbtO2 -- 12.3.1 Systemic Determinants of PbtO2 -- 12.3.2 The Balance of Supply and Demand -- 12.3.3 Local Tissue Factors Influencing PbtO2 Readings -- 12.4 Brain Tissue Oxygen Monitoring in TBI -- 12.4.1 Ischemia as a Component of Secondary Brain Injury in TBI -- 12.4.2 Mechanisms of Brain Hypoxia and Dysoxia. |
12.4.3 Identification of Brain Hypoxia with PbtO2 -- 12.4.4 Outcomes Associated with Low PbtO2 -- 12.4.5 Protocolized Approach to Brain Hypoxia -- 12.4.6 Randomized Trials of PbtO2-Based Management in TBI -- 12.5 Brain Tissue Oxygen Monitoring in SAH -- 12.5.1 Mechanisms of Brain Injury in SAH -- 12.6 PbtO2 Monitoring in SAH -- 12.6.1 Evidence for PbtO2 Use in SAH -- 12.7 The Future of Brain Oxygen Monitoring in Acute Brain Injury -- 12.7.1 Indices of Auto-regulation -- 12.7.2 Use of PbtO2 Monitoring in CSD -- 12.8 Conclusions -- References -- 13: Brain Microdialysis -- 13.1 Introduction -- 13.2 The Principle of Microdialysis -- 13.3 Factors Affecting Solute Recovery -- 13.3.1 Flow Rate of Perfusate -- 13.3.2 Characteristics of Semipermeable Membrane -- 13.3.3 Characteristics of Analyte -- 13.3.4 Temperature -- 13.3.5 Tissue Factors -- 13.4 Clinical Applications of Microdialysis in Brain Injury -- 13.4.1 Aneurysmal Subarachnoid Hemorrhage -- 13.4.2 Traumatic Brain Injury -- 13.4.3 Acute Ischemic Stroke -- 13.4.4 Brain Tumor -- 13.4.5 Epilepsy -- 13.5 Other Applications of Cerebral Microdialysis -- 13.6 Future Applications -- References -- 14: Neuroimaging: CT Scan and MRI -- 14.1 Introduction -- 14.2 Imaging Modalities -- 14.2.1 Computed Tomography -- 14.2.2 Magnetic Resonance Imaging -- 14.2.3 Basic Sequences of MRI -- 14.2.4 Digital Subtraction Angiography -- 14.3 Different Spectrum of Pathology -- 14.4 Summary -- References -- 15: Brain Ultrasonography -- 15.1 |
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Introduction -- 15.2 Principles of Brain Ultrasound -- 15.3 Clinical Applications -- 15.3.1 Midline Shift -- 15.3.2 Intraparenchymal Hemorrhage -- 15.3.3 Extra-axial Hemorrhage -- 15.3.4 Hydrocephalus -- 15.3.5 Post-surgical Applications -- 15.3.6 Limitations of Brain Ultrasound -- 15.3.7 Orbital Ultrasound -- 15.3.8 Optic Nerve Sheath Diameter. |
15.3.9 Papilledema. |
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