Report a case of Superior Vena Cava Syndrome (SVCS) causing cerebral venous infarcts and hemorrhage likely from venous congestion; and review literature on intracranial hemorrhage (ICH) in SVCS.
This survey summarises some aspects of critical-care treatment of acute ischemic stroke. Special emphasis is put on the management of raised intracerebral pressure, the use of thrombolytic therapy, general management procedures, such as blood pressure control and metabolic monitoring, in acute ischemic stroke. The indications for surgical intervention in major space-occupying infarction are discussed.
Outcome prediction is more difficult in comatose survivors of cardiac arrest who are treated with hypothermia than in those who are kept normothermic. This article compares prognostication measures in these two groups of patients.The introduction of therapeutic hypothermia for cardiac arrest has resulted in reduced mortality and better neurologic outcomes among survivors. However, it has also introduced greater uncertainty into the process of prognostication. For guidance on predicting outcome, most neurologists have relied on the 2006 AAN practice parameter. The studies on which the practice parameter was based, however, were performed before the advent of hypothermia. Data from posthypothermia era studies suggest a change in the predictive power of some markers that are regularly used to assess prognosis in post-cardiac arrest patients. It is unclear whether the same rules apply when predicting outcomes after cardiac arrest in cooled patients. In this new era of hypothermia, caution must be exercised when using the current AAN practice parameter to predict prognosis in post-cardiac arrest comatose survivors.This article compares and contrasts prognostication before and after the introduction of hypothermia in an attempt to provide new guidance on predicting outcomes.
Abstract Over the last century, significant milestones have been achieved in managing critical illness and diagnosing and treating neurological diseases. Building upon these milestones, the field of neurocritical care emerged in the 1980 and 1990 s at the convergence of critical care medicine and acute neurological treatment. This comprehensive review presents a historical account of key developments in neurocritical care in both the United States and Europe, with a special emphasis on German contributions. The scope of the review encompasses: the foundations of neurocritical care, including post-operative units in the 1920s and 30s, respiratory support during the poliomyelitis epidemics in the 40 and 50 s, cardiac and hemodynamic care in the 60 and 70 s, and stroke units in the 80 and 90 s; key innovations including cerebral angiography, computed tomography, and intracranial pressure and multi-modal monitoring; and advances in stroke, traumatic brain injury, cardiac arrest, neuromuscular disorders, meningitis and encephalitis. These advances have revolutionized the management of neurological emergencies, emphasizing interdisciplinary teamwork, evidence-based protocols, and personalized approaches to care.
