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Lost in Translational Neurology: From Anemic Decerebration to Anoxic-Ischemic Brain Injury

By Eelco F. M. Wijdicks First Online: 10 February 2020 Experiments in which animals were exposed to interruption of blood flow were far removed from the bedside evaluation of patients with anoxic-ischemic brain injury. In the early 1900s, laboratory scientists created “acute anemia” ...


Blog Entry
Through the Eyes of Monkeys: Questions About Uncal Herniation

By Eelco F. M. Wijdicks First Online: 10 February 2020 When neurointensivists go in for brain cutting their deceased patient will often display herniation of the uncus of the temporal lobe. We can see compression of the third nerve that is often pointed out by the scalpel. As expected,...


Blog Entry
The Clinicians Who Recognized Meningitis

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...


Blog Entry
Suspended (but No Animation) White’s Isolated Brain Experiments

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...


Blog Entry
Charcot–Bouchard Dilatations (Anevrysmes Miliaire) and the Search for the Cause of Cerebral Hemorrhage

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 ]....


Blog Entry
Recording Neurogenic Breathing Patterns in Acute Brain Injury

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...


Blog Entry
Breaking Down Myasthenic Crisis

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...


Blog Entry
When Did We Start Talking About no Recovery in Critical Illness?

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...


Blog Entry
Homage to the Pioneers and Their Treatment of Spinal Cord Injury

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...


Blog Entry
Brain Storming in Brain Trauma

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...