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The Tangled History of Brain–Heart Pathways in Acute Brain Injury

By Eelco F. M. Wijdicks First Online: 02 March 2021 When we try to reconstruct the complex discovery of heart–brain pathways, we find it has been moving from bench to bedside and back. Perhaps a good moment to start is around the turn of the century with Cushing, who among other European...


Blog Entry
The Discovery of Acute Alcohol Withdrawal as a Cause of Delirium

By Eelco F. M. Wijdicks First Online: 02 March 2021 For heavy drinkers to come into a hospital carries risks, and worryingly, signs associated with imposed abstinence appear soon after admission. A considerable number could be transferred to intensive care units including neurointensive care...


Blog Entry
Historical Appreciation of Brain Vulnerability from Pure Hypoxemia

By Eelco F. M. Wijdicks First Online : 23 February 2021 Even more now than in the recent past, neurointensivists are asked to evaluate the effects of hypoxemia on the brain. The SARS-CoV-2 pandemic, characterized by widespread transmission and admitting patients by the thousands, requires...


Blog Entry
Von Leyden’s Contribution to the Elusive Syndrome of Acute Basilar Artery Occlusion

By Eelco F. M. Wijdicks First Online : 09 February 2021 Early recognition of acute basilar artery embolus has remained problematic, and clinical signs are not commonly interpreted as dire. The syndrome, despite its familiar (textbook) clinical presentation, historically has remained elusive...


Blog Entry
Finding the Right Osmotic Agent: Why Mannitol Prevailed

By Eelco F. M. Wijdicks First Online: 09 February 2021 For decades, surgeons and neurosurgeons sought ways to shrink the brain to reduce compression from a mass. The simple physiologic concept of osmosis was well known, and as early as 1918, intravenous glucose was used to attract water...


Blog Entry
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
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...