Blogs

Be the first person to recommend this.
Title: Academic Neurocritical Care Faculty Position Company: University of Maryland School of Medicine Department: Section of Neurocritical Care, Program in Trauma Position: Neurocritical Care Faculty Description: The Program in Trauma at the University Of Maryland School Of Medicine is recruiting faculty for the Section of Neurocritical Care to work in both the NeuroCritical Care Unit (NCCU) at the University of Maryland Medical Center (UMMC) as well as a new NCCU to be opened in the UMMC-Midtown campus. The NCC team is comprised of a multidisciplinary team of Neurointensivists from the Departments of Neurology, Neurosurgery and Anesthesiology, ...
0 comments
Be the first person to recommend this.
By Kristi Lanning, MD   Trainees are taught how to communicate with patients and how to behave professionally during patient interactions, but sadly there is much less emphasis placed on effective communication with medical colleagues.  In residency programs, there is little, if any, formal instruction and most of the learning comes from observation.  However, mastery of these skills is an important part of providing consultation services.  Also, notably, two of the six Accreditation Council for Graduate Medical Education (ACGME) core competencies for residents are 1) professionalism and 2) interpersonal and communication skills. Rooted in the key ethical ...
0 comments
Be the first person to recommend this.
To most, Sunday, April 7, 2019, does not stir up strong emotions or even spark a distant memory. The most popular tweet of the day was “Keep your emotions off the internet” from NFL player JuJu Smith-Schuster; Old Town Road by Lil Nas X jumped 14 spots to No. 1 on the Billboard Hot 100; front page news introduced Candida auris to the public; and in just 24 hours, the Virginia Cavaliers would face the Texas Tech Red Raiders in the NCAA college basketball national championship game. But that day was a big one for Kertisha “Tisha” Brabson and her battle against a relentless disease, because at 5:10 a.m. she opened her eyes and followed simple ...
0 comments
Be the first person to recommend this.
Amarenco P, Kim JS, Labreuche H, et al.  A comparison of two LDL cholesterol targets after ischemic stroke.  NEJM 2020; 382:9-19.   Reviewed by Kyle Hobbs, MD Read the article .   Summary :  Intensive lipid lowering therapy is recommended after ischemic stroke or TIA, but the exact LDL target is unclear. The Treat Stroke to Target trial is an international, multicenter, randomized, parallel-group, event driven trial comparing a target LDL of < 70 mg/dL to a target of 90-110 mg/dL after ischemic stroke or TIA in patients with atherosclerosis.  Adult patients were eligible for enrollment if they had had an ischemic stroke in the past 3 months ...
0 comments
Be the first person to recommend this.
Barletta JF, Abdul-Rahman D, Hall ST, Mangram AJ, Dzandu JK, Frontera JA, Zach V. The role of desmopressin on hematoma expansion in patients with mild traumatic brain injury prescribed pre-injury antiplatelet medications. Neurocritical Care. 2020 Jan 2. doi: 10.1007/s12028-019-00899-x Reviewed by Alexis Steinberg, MD   Read the article .*   *You will need to log in to US National Library of Medicine National Institutes of Health to read this article.     Methods: An increased risk for traumatic intracerebral hemorrhage (ICH) and expansion of nontraumatic ICH has been associated with antiplatelet use. Guidelines exist for antiplatelet ...
0 comments
Be the first person to recommend this.
By Nicolas Alejandro Gemelli, Luis Alejandro Boccalatte & Nicolas Marcelo Ciarrocchi First Online: 31 January 2020 References 1. Belkacem A, Caseris M, Yazdanpanah Y. A case of Aggregatibacter aphrophilus multiple abscess. Open Forum Inf Dis. 2015;2(2):ofv031. 2. Nørskov N. Classification, identification, and clinical significance of Haemophilus and Aggregatibacter species with host specificity for humans. Clin Micobiol Rev. 2014;27(2):214–40. 3. Arlotti M, Grossi P, Pea F, Tomei G, Vullo V, De Rosa FG, et al. Consensus document on controversial issues for the treatment of infections of the central nervous system: bacterial brain abscesses. ...
0 comments
Be the first person to recommend this.
By Emma E. Meyers, Alex Presciutti, Kelly M. Shaffer, Melissa Gates, Ann Lin, Jonathan Rosand & Ana-Maria Vranceanu First Online: 29 January 2020 Background/Objective Anxiety is common in patients experiencing neurocritical illness and their family caregivers. Resilience factors like mindfulness and coping skills may be protective against symptoms of emotional distress, including anxiety. Less is known about the interplay of anxiety symptoms and resilience factors between patients and caregivers. The purpose of this study is to examine the trajectory of anxiety symptoms among dyads of neurocritical care patients without major cognitive impairment ...
0 comments
Be the first person to recommend this.
By Eelco F. M. Wijdicks MD, PhD First Online: 28 January 2020 References 1. Tyler KL. A history of bacterial meningitis. In: Finger S, Boller F, Tyler KL, editors. Handbook of clinical neurology. Amsterdam: Elsevier; 2010. p. 417–33. 2. Abercrombie J. Pathological and practical researches on diseases of the brain and the spinal cord. Waugh and Innes: Edinburgh; 1831. 3. Herpin F. Meningite, au Inflammation des Membranes de I’Enciphale: pricede de quelques cOflsider.lIions phy-siologiques sur ces membranes. suivi de plusieurs observa-lions recuellllcs a l’aml6e du Rhin. Paris; 1803. 4. Quincke H. Die Lumbalpunction des Hydrocephalus. Berl Klin Wochenschr. ...
0 comments
Be the first person to recommend this.
By Aravind V. Ramesh, Charis F. K. Banks, Peter E. Mounstephen, Kate Crewdson & Matt Thomas First Online: 28 January 2020 Background/objective Sympathetic nervous system activation after aneurysmal subarachnoid hemorrhage (aSAH) is associated with complications and poor outcome. In this systematic review and meta-analysis, we investigate the effect of beta-blockers on outcome after aSAH. Methods The review was prospectively registered with PROSPERO (CRD42019111784). We performed a systematic literature search of MEDLINE, EMBASE, the Cochrane Library, published conference proceedings, and abstracts. Eligible studies included both randomized ...
0 comments
Be the first person to recommend this.
By Eelco F. M. Wijdicks MD, PhD First Online: 27 January 2020 Decapitation—and what it means for the brain—was back in the news. Vrselja and his coworkers from Yale use a decapitated pig brain and, after connecting to extracorporeal perfusion system, were able to postpone biochemical decline and swelling with a preservative called  BrainEx  (i.e., synthetic, hemoglobin-based, cytoprotective perfusate and consisting of vitamins and minerals) [ 1 ]. The brains, 4 h after their heads were severed from the slaughterhouse, were connected to the device—through the carotid arteries only—for about 10 h. The researchers found that individual neurons were ...
0 comments
Be the first person to recommend this.
By Eelco F. M. Wijdicks MD, PhD First Online: 24 January 2020 Cerebral hemorrhage had been recognized since Johann Jakob Wepfer in 1658 reported it as a cause of apoplexy ( Schlaganfall ). At autopsy, he would find sanguineous fluid within cavities of the brain [ 1 , 2 , 3 ]. Hemorrhage due to abnormal arteries was investigated as early as the nineteenth century with John Cheyne (1777–1836), who believed it to be a result of a bleeding vascular malformation [ 4 ]. It became much more interesting when Jean-Martin Charcot (12 years his senior) asked his resident Charles Bouchard to study the pathogenesis of cerebral hemorrhage. This work resulted ...
0 comments
Be the first person to recommend this.
By Eelco F. M. Wijdicks First Online: 24 January 2020 In 1972, North and Jennett stated in the  Lancet : “Abnormal breathing is often regarded as an incidental feature of brain damage, and little clinical attention is paid to it” [ 1 ]. It is very true: the changes in respiratory rate and rhythm are not always appreciated or recognized, and endotracheal intubation (with sedation and paralytic agents) will make any observation moot. Read full article . #NeurocriticalCareHistory
0 comments
Be the first person to recommend this.
By Eelco F. M. Wijdicks MD, PhD Myasthenia gravis may not be known to the patient before fulminant worsening of swallowing and breathing occurs. Respiratory weakness has reportedly appeared without prior diagnosis, but the absence of some prior signs is improbable. Myasthenia gravis does not proceed in a steady downhill course; instead, it progresses with stops and starts until, at some point, it requires close monitoring in an intensive care unit. There is a general understanding that myasthenia gravis becomes a “crisis” once airway or respiratory support is needed. Experts in treatment of myasthenia gravis have struggled with the definition of rapid, ...
0 comments
Be the first person to recommend this.
By Eelco F. M. Wijdicks MD, PhD First Online: 24 January 2020 Neurointensivists (and intensivists) accept the responsibility for their decisions when they determine that outcome will be realistically poor. How did we do it in the past? For many years (and even decades), physicians, and later neurosurgeons, would decide that a catastrophically injured patient was in a medically irretrievable situation, totally beyond recovery and irrevocably damaged. These strong words would be communicated at the bedside to family members, who would often agree—because that’s what they thought they saw too—and leave decisions in the physician’s capable hands. Read ...
0 comments
Be the first person to recommend this.
By Eelco F. M. Wijdicks MD, PhD First Online: 24 January 2020 The history of the management of traumatic spinal cord injury (TSCI) goes a long way back and is closely connected to wartime [ 1 , 2 , 3 ]. Initially, garrison military hospitals tended to the wounded, but medical centers quickly became involved. In the USA, the Civil War introduced spine trauma to the neurologist. Although not directly involved with patient care, the neurologist and scientist Brown–Séquard, for example, pointed out that spinal cord compression by bony fragments could cause more damage than direct injury of the spine. He also noted wounds could lead to tetanus, for ...
0 comments
Be the first person to recommend this.
By Eelco F. M. Wijdicks First Online: 24 January 2020 When the autonomic system is touched or damaged, it shows clinically and often dramatically. First, neurosurgeons recognized impressive autonomic manifestations after surgery for tumors in the hypothalamic area. Neurologists often saw similar sympathetic responses in acute bulbar forms of poliomyelitis [ 1 ,  2 ] and in patients in prolonged coma from major brain injury. Subsequently introduced terms, such as “sympathetic storms,” emphasized the sporadic nature of the episodes [ 3 , 4 , 5 , 6 , 7 ]. Read full article . #NeurocriticalCareHisto
0 comments
Be the first person to recommend this.
By Venus Kit Sze Wu, Christine Fong, Andrew M. Walters & Abhijit V. Lele First Online:   23 January 2020 Background The prevalence, characteristics, and outcomes related to the ventilator-associated event(s) (VAE) in neurocritically ill patients are unknown and examined in this study. Methods A retrospective study was performed on neurocritically ill patients at a 413-bed level 1 trauma and stroke center who received three or more days of mechanical ventilation to describe rates of VAE, describe characteristics of patients with VAE, and examine the association of VAE on ventilator days, mortality, length of stay, and discharge to home. ...
0 comments
Be the first person to recommend this.
Title: Duke Neurocritical Care Company: Duke Health Department: Neurology Position: Duke Neurocritical Care Expertise: Neurocritical Care Region: Durham, NC Description: The Department of Neurology at Duke University School of Medicine is seeking two additional BC/BE fellowship trained Neurocritical Care physicians at the Associate or Assistant Professor level, due to Neuro ICU expansion. Successful hires will enjoy an active clinical practice with the ability to advance their academic career in medical education and/or clinical and translational research. New Division Chief for Neurocritical Care is committed to faculty mentorship. Interested ...
0 comments
Be the first person to recommend this.
Title: Faculty, Neurocritical Care Company: University of Florida, College of Medicine Department: Neurology Position: Ast/Aso/Full Professor Expertise: Neurocritical Care/Neurology Region: Florida Salary Range: Competitive Description: The Department of Neurology, at the University of Florida invites outstanding applicants for consideration for multiple full-time, open rank, tenure or non-tenure track faculty positions, in the Neurocritical Care Division. Join a growing group of 5 neurocritical care faculty in a busy and growing academic program. Our 32-bed neuroICU is located in the recently opened Neuromedicine hospital. Our program ...
0 comments
Be the first person to recommend this.
Title: Neurocritical Care Advanced Practice Provider Company: University of Florida, College of Medicine Department: Neurology Position: Advanced Practice Provider Expertise: Neurology, Critical Care Region: Florida Salary Range: Competitive Description: University of Florida Health Shands is currently seeking advanced practice providers to join our growing neurocritical care program. Join a growing group of APPs, faculty, residents, and fellows in a busy and growing academic program with a 32-bed neuroICU, all while enjoying the benefits of living in Florida. We are seeking to hire Advanced Practice Providers – NPs or PAs with critical ...
0 comments