Hyunsoo Kim, T. Nam, M. Levy, Kyung-Hwa Lee, Jahae Kim, Seung Jin Lee
lymphoma with intramedullary spinal cord involvement mimicking inflammatory demyelinating disease Hyunsoo Kim, MD; Tai-Seung Nam, MD, PhD; Michael Levy, MD, PhD; Kyung-Hwa Lee, MD, PhD; Jahae Kim, MD, PhD; Seung-Jin Lee, MD Department of Neurology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA Department of Pathology, Chonnam National University Medical School, Gwangju, Republic of Korea Department of Nuclear Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea Department of Radiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea CASE REPORT
淋巴瘤伴髓内脊髓受累，模拟炎症性脱髓鞘疾病Hyunsoo Kim，医学博士；Tai Seung Nam，医学博士、博士；Michael Levy，医学博士、博士；Kyung Hwa Lee，医学博士、博士；Jahae Kim，医学博士、博士；Seung Jin Lee，全南国立大学医院神经内科医学博士，全南州立大学医学院，韩国光州，马萨诸塞州总医院，哈佛医学院，马萨诸塞州波士顿，美国病理学系，全南公立大学医学院，韩国光州全南国立大学医院、韩国光州全南国立大学医学院放射科、韩国光洲全南国立大医院、韩国全南国立大医学院病例报告
{"title":"Primary central nervous system lymphoma with intramedullary spinal cord involvement mimicking inflammatory demyelinating disease","authors":"Hyunsoo Kim, T. Nam, M. Levy, Kyung-Hwa Lee, Jahae Kim, Seung Jin Lee","doi":"10.18700/JNC.190083","DOIUrl":"https://doi.org/10.18700/JNC.190083","url":null,"abstract":"lymphoma with intramedullary spinal cord involvement mimicking inflammatory demyelinating disease Hyunsoo Kim, MD; Tai-Seung Nam, MD, PhD; Michael Levy, MD, PhD; Kyung-Hwa Lee, MD, PhD; Jahae Kim, MD, PhD; Seung-Jin Lee, MD Department of Neurology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA Department of Pathology, Chonnam National University Medical School, Gwangju, Republic of Korea Department of Nuclear Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea Department of Radiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea CASE REPORT","PeriodicalId":33246,"journal":{"name":"Journal of Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49194768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
review is to help understand the physiological changes during pregnancy and postpartum, and to inform treatment decisions regarding pregnancy-related cerebro-vascular complications.
综述旨在帮助了解妊娠期和产后的生理变化，并为妊娠相关脑血管并发症的治疗决策提供信息。
{"title":"Cerebrovascular complications during pregnancy and postpartum","authors":"Jeong‐Ho Hong","doi":"10.18700/JNC.190087","DOIUrl":"https://doi.org/10.18700/JNC.190087","url":null,"abstract":"review is to help understand the physiological changes during pregnancy and postpartum, and to inform treatment decisions regarding pregnancy-related cerebro-vascular complications.","PeriodicalId":33246,"journal":{"name":"Journal of Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46263864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Patients with persistent vegetative state (PVS) show no evidence of awareness of self or their environment, and those with minimally conscious state (MCS) have severely impaired consciousness with minimal but definite behavioral evidence of self or environmental awareness after stroke. Neuroimaging and clinical characteristics separating these two close consciousness states after stroke were insufficiently studied. Methods: We conducted a hospital-based cohort study of all patients with stroke (2011 to 2017) who underwent 3T magnetic resonance imaging and consciousness assessment after 3 months of inclusion. Univariate and multivariate regression analyses were used to estimate the relative risk of neuroimaging markers for differentiation of PVS and MCS. Results: Of 3,600 eligible subjects, 323 patients (0.09%) had PVS and 93 (0.02%) had MCS (mean age, 62.25±13.4 years). Higher stroke volume was strongly associated with PVS compared to MCS (odds ratio [OR], 0.99; 95% confidence interval [CI], 0.98 to 1.00; P=0.001). On univariate analysis, cingulate gyrus (OR, 2.7; 95% CI, 1.62 to 4.36; P=0.001) and corpus callosum (OR, 2.1; 95% CI, 1.28 to 3.44; P=0.003) involvement was significantly associated with PVS. However, on multivariate analysis, only cingulate gyrus involvement was independently associated with PVS (OR, 2.2; 95% CI, 1.33 to 3.72; P=0.002). Conclusion: Our results indicate that PVS and MCS are different consciousness states according to clinical and neuroimaging findings. To predict outcome, cognitive performance of these patients should be well questioned after stroke.
{"title":"Clinical and neuroimaging determinants of minimally conscious and persistent vegetative states after acute stroke","authors":"E. Kumral, F. Bayam, Bedriye Köken, C. Erdoğan","doi":"10.18700/JNC.190080","DOIUrl":"https://doi.org/10.18700/JNC.190080","url":null,"abstract":"Background: Patients with persistent vegetative state (PVS) show no evidence of awareness of self or their environment, and those with minimally conscious state (MCS) have severely impaired consciousness with minimal but definite behavioral evidence of self or environmental awareness after stroke. Neuroimaging and clinical characteristics separating these two close consciousness states after stroke were insufficiently studied. Methods: We conducted a hospital-based cohort study of all patients with stroke (2011 to 2017) who underwent 3T magnetic resonance imaging and consciousness assessment after 3 months of inclusion. Univariate and multivariate regression analyses were used to estimate the relative risk of neuroimaging markers for differentiation of PVS and MCS. Results: Of 3,600 eligible subjects, 323 patients (0.09%) had PVS and 93 (0.02%) had MCS (mean age, 62.25±13.4 years). Higher stroke volume was strongly associated with PVS compared to MCS (odds ratio [OR], 0.99; 95% confidence interval [CI], 0.98 to 1.00; P=0.001). On univariate analysis, cingulate gyrus (OR, 2.7; 95% CI, 1.62 to 4.36; P=0.001) and corpus callosum (OR, 2.1; 95% CI, 1.28 to 3.44; P=0.003) involvement was significantly associated with PVS. However, on multivariate analysis, only cingulate gyrus involvement was independently associated with PVS (OR, 2.2; 95% CI, 1.33 to 3.72; P=0.002). Conclusion: Our results indicate that PVS and MCS are different consciousness states according to clinical and neuroimaging findings. To predict outcome, cognitive performance of these patients should be well questioned after stroke.","PeriodicalId":33246,"journal":{"name":"Journal of Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44041133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Generalized periodic discharges (GPDs) are electroencephalographic (EEG) waveforms that can be seen in a wide array of encephalopathies. By definition, they are repeated and generalized waveforms with relatively uniform morphology and duration, with a quantifiable interdischarge interval between consecutive waveforms, and recurrence of the waveform at nearly regular intervals (Fig. 1) [1]. There are different theories for their etiology and pathophysiology. Early work suggested that GPDs were due to widespread cortical destruction with relative sparing of white Generalized periodic discharges (GPDs) with triphasic morphology are an electroencephalographic (EEG) pattern traditionally associated with encephalopathy and coma, although they have been observed in a wide array of neurological disorders. The clinical significance of these waveforms and their relationship to seizures and prognosis has been debated, and differentiation between interictal patterns, patterns associated with seizures, and patterns representing nonconvulsive status epilepticus can at times be a challenge. The most established literature suggests that GPDs, including those with triphasic morphology, are associated with the development of electrographic seizures, but that in the absence of clinical information, distinguishing waveforms based on morphology alone may not be clinically useful. Recent work has advocated for a more proactive approach in evaluating GPDs with triphasic morphology. Further studies of nonsedating antiseizure drugs in patients with GPDs with triphasic morphology that incorporate continuous EEG monitoring will be useful in tailoring therapy to optimize long-term clinical outcomes and recovery.
{"title":"Generalized periodic discharges with triphasic morphology","authors":"J. Hartshorn, B. Foreman","doi":"10.18700/JNC.190079","DOIUrl":"https://doi.org/10.18700/JNC.190079","url":null,"abstract":"Generalized periodic discharges (GPDs) are electroencephalographic (EEG) waveforms that can be seen in a wide array of encephalopathies. By definition, they are repeated and generalized waveforms with relatively uniform morphology and duration, with a quantifiable interdischarge interval between consecutive waveforms, and recurrence of the waveform at nearly regular intervals (Fig. 1) [1]. There are different theories for their etiology and pathophysiology. Early work suggested that GPDs were due to widespread cortical destruction with relative sparing of white Generalized periodic discharges (GPDs) with triphasic morphology are an electroencephalographic (EEG) pattern traditionally associated with encephalopathy and coma, although they have been observed in a wide array of neurological disorders. The clinical significance of these waveforms and their relationship to seizures and prognosis has been debated, and differentiation between interictal patterns, patterns associated with seizures, and patterns representing nonconvulsive status epilepticus can at times be a challenge. The most established literature suggests that GPDs, including those with triphasic morphology, are associated with the development of electrographic seizures, but that in the absence of clinical information, distinguishing waveforms based on morphology alone may not be clinically useful. Recent work has advocated for a more proactive approach in evaluating GPDs with triphasic morphology. Further studies of nonsedating antiseizure drugs in patients with GPDs with triphasic morphology that incorporate continuous EEG monitoring will be useful in tailoring therapy to optimize long-term clinical outcomes and recovery.","PeriodicalId":33246,"journal":{"name":"Journal of Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44426349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 59-year-old man underwent endoscopic balloon dilation for esophageal stricture. Upon the completion of the procedure, he was observed to be stuporous and quadriplegic. Computed tomography (CT) of the brain revealed multiple air emboli (Fig. 1A). Magnetic resonance imaging (MRI) performed 45 minutes after symptom onset revealed multiple lesions showing signal loss on susceptibility-weighted imaging, high signal intensity on diffusion-weighted imaging, and diffuse enhancement on T1-weighted contrast-enhanced imaging, which were compatible with air emboli, hyperacute infarcts, and a disrupted bloodbrain barrier, respectively (Fig. 1B-1D). Hyperbaric oxygen therapy (HBOT) was administered 80 minutes after MRI (targeting 3.0 atmospheric pressure for 2 hours). Follow-up CT performed 80 minutes after HBOT revealed disappearance of the air emboli (Fig. 1E). Follow-up MRI performed 5 days after HBOT also revealed a decrease in the resolution of previously documented findings (Fig. 1F-1H). Most of his neurological symptoms improved, except mild left hemiparesis. This case indicates that MRI is a useful modality in diagnosing cerebral air embolism by documenting air emboli, hyperacute infarcts, and disruption of the blood–brain barrier [1-3]. HBOT may accelerate the disappearance of air emboli and proIMAGES IN NEUROCRITICAL CARE
{"title":"Cerebral air embolism treated using hyperbaric oxygen therapy","authors":"Yeon-Jung Kim, Sang-beom Jeon","doi":"10.18700/JNC.190085","DOIUrl":"https://doi.org/10.18700/JNC.190085","url":null,"abstract":"A 59-year-old man underwent endoscopic balloon dilation for esophageal stricture. Upon the completion of the procedure, he was observed to be stuporous and quadriplegic. Computed tomography (CT) of the brain revealed multiple air emboli (Fig. 1A). Magnetic resonance imaging (MRI) performed 45 minutes after symptom onset revealed multiple lesions showing signal loss on susceptibility-weighted imaging, high signal intensity on diffusion-weighted imaging, and diffuse enhancement on T1-weighted contrast-enhanced imaging, which were compatible with air emboli, hyperacute infarcts, and a disrupted bloodbrain barrier, respectively (Fig. 1B-1D). Hyperbaric oxygen therapy (HBOT) was administered 80 minutes after MRI (targeting 3.0 atmospheric pressure for 2 hours). Follow-up CT performed 80 minutes after HBOT revealed disappearance of the air emboli (Fig. 1E). Follow-up MRI performed 5 days after HBOT also revealed a decrease in the resolution of previously documented findings (Fig. 1F-1H). Most of his neurological symptoms improved, except mild left hemiparesis. This case indicates that MRI is a useful modality in diagnosing cerebral air embolism by documenting air emboli, hyperacute infarcts, and disruption of the blood–brain barrier [1-3]. HBOT may accelerate the disappearance of air emboli and proIMAGES IN NEUROCRITICAL CARE","PeriodicalId":33246,"journal":{"name":"Journal of Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49569660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cerebral air embolism is a rare but potentially severe complication of iatrogenic procedures or destructive lung disease, possibly resulting in neurological disorders such as encephalopathy, stroke, or seizure. Due to a low overall incidence, cerebral air embolism may go undiagnosed. We report the case of a patient with cerebral air embolism presenting with status epilepticus after the Valsalva maneuver during a pulmonary function test. CASE REPORT
{"title":"Status epilepticus due to cerebral air embolism after the Valsalva maneuver","authors":"H. Lyou, Hye-Jeong Lee, G. Lee, Won-Joo Kim","doi":"10.18700/JNC.190075","DOIUrl":"https://doi.org/10.18700/JNC.190075","url":null,"abstract":"Cerebral air embolism is a rare but potentially severe complication of iatrogenic procedures or destructive lung disease, possibly resulting in neurological disorders such as encephalopathy, stroke, or seizure. Due to a low overall incidence, cerebral air embolism may go undiagnosed. We report the case of a patient with cerebral air embolism presenting with status epilepticus after the Valsalva maneuver during a pulmonary function test. CASE REPORT","PeriodicalId":33246,"journal":{"name":"Journal of Neurocritical Care","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41336028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sjögren’s syndrome (SjS) is a chronic autoimmune disease that may be primary or secondary to other connective tissue disorders, particularly rheumatoid arthritis, systemic lupus erythematosus, and systemic sclerosis. SjS is clinically characterized by sicca symptoms, which develop due to a mononuclear infiltration and secondary chronic dysfunction of the lacrimal and salivary glands. Systemic, extra-glandular manifestations are found in many patients with primary SjS and may occur in almost any organ, including the nervous system. The central nervous system CASE REPORT
{"title":"Recurrent aseptic meningitis as an initial clinical presentation of primary Sjögren’s syndrome","authors":"D. H. Lee, S. Lee","doi":"10.18700/JNC.190077","DOIUrl":"https://doi.org/10.18700/JNC.190077","url":null,"abstract":"Sjögren’s syndrome (SjS) is a chronic autoimmune disease that may be primary or secondary to other connective tissue disorders, particularly rheumatoid arthritis, systemic lupus erythematosus, and systemic sclerosis. SjS is clinically characterized by sicca symptoms, which develop due to a mononuclear infiltration and secondary chronic dysfunction of the lacrimal and salivary glands. Systemic, extra-glandular manifestations are found in many patients with primary SjS and may occur in almost any organ, including the nervous system. The central nervous system CASE REPORT","PeriodicalId":33246,"journal":{"name":"Journal of Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42402856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Seong-Joon Lee, Kyu Sun Lee, J. S. Lee, M. H. Choi, S. E. Lee, Ji-Hee Hong
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{"title":"Primary neurocritical care involving therapeutic hypothermia for acute ischemic stroke patients with malignant infarct cores","authors":"Seong-Joon Lee, Kyu Sun Lee, J. S. Lee, M. H. Choi, S. E. Lee, Ji-Hee Hong","doi":"10.18700/JNC.190076","DOIUrl":"https://doi.org/10.18700/JNC.190076","url":null,"abstract":",","PeriodicalId":33246,"journal":{"name":"Journal of Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45818766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jongsoo Kang, Chul-Hoo Kang, J. Roh, J. Yeom, D. Shim, Youngsoo Kim, Sang Won Lee, Young-Soo Kim, K. Park, Chang-Hun Kim, Soo-Kyoung Kim, Nack-Cheon Choi, O. Kwon, H. Kang, S. Baik
Department of Neurology and Institute of Health Science, Gyeongsang National University College of Medicine, Jinju; Department of Radiology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan; Deaprment of Neurology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon; Department of Neurosurgery, MH Yeonse Hospital, Changwon; Department of Neurosurgery, Pusan National University Yangsan Hospital, Pusan National University School of medicine, Yangsan; Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
{"title":"Feasibility, Safety, and Follow-up Angiographic Results of Endovascular Treatment for Non-Selected Ruptured Intracranial Aneurysms Under Local Anesthesia with Conscious Sedation","authors":"Jongsoo Kang, Chul-Hoo Kang, J. Roh, J. Yeom, D. Shim, Youngsoo Kim, Sang Won Lee, Young-Soo Kim, K. Park, Chang-Hun Kim, Soo-Kyoung Kim, Nack-Cheon Choi, O. Kwon, H. Kang, S. Baik","doi":"10.18700/JNC.180059","DOIUrl":"https://doi.org/10.18700/JNC.180059","url":null,"abstract":"Department of Neurology and Institute of Health Science, Gyeongsang National University College of Medicine, Jinju; Department of Radiology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan; Deaprment of Neurology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon; Department of Neurosurgery, MH Yeonse Hospital, Changwon; Department of Neurosurgery, Pusan National University Yangsan Hospital, Pusan National University School of medicine, Yangsan; Department of Radiology, Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea","PeriodicalId":33246,"journal":{"name":"Journal of Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45172004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nutritional assessment and support are often overlooked in the critically ill due to other urgent priorities. Unlike oxygenation, organ dysfunction, infection, or consciousness, there is no consensus of indicators. Making it difficult to evaluate the effectiveness of an intervention. Nevertheless, appropriate nutritional support in the critically ill has been associated with less morbidity and lower mortality. But, nutritional support has been considered an adjunct, for body weight maintenance and to help patients during the inflammatory phase of illness. Thus, it has been assigned a lower priority, compared to mechanical ventilation or hemodynamic stability. Recent findings have shown that nutritional support may prevent cellular injury due to oxidative stress and help strengthen the immune response. Largescale randomized trials and clinical guidelines have shown a shift from nutritional support to nutritional therapy, with an emphasis on the importance of protein, minerals, vitamins, and trace elements. Nutrition is also important in neurocritically ill patients. Since there are few studies or recommendations with regard to the neurocritical population, the general recommendations for nutritional support should be applied.
{"title":"Nutritional Support for Neurocritically Ill Patients","authors":"H. Jeong, Soo-Hyun Park, H. Ryu","doi":"10.18700/JNC.180070","DOIUrl":"https://doi.org/10.18700/JNC.180070","url":null,"abstract":"Nutritional assessment and support are often overlooked in the critically ill due to other urgent priorities. Unlike oxygenation, organ dysfunction, infection, or consciousness, there is no consensus of indicators. Making it difficult to evaluate the effectiveness of an intervention. Nevertheless, appropriate nutritional support in the critically ill has been associated with less morbidity and lower mortality. But, nutritional support has been considered an adjunct, for body weight maintenance and to help patients during the inflammatory phase of illness. Thus, it has been assigned a lower priority, compared to mechanical ventilation or hemodynamic stability. Recent findings have shown that nutritional support may prevent cellular injury due to oxidative stress and help strengthen the immune response. Largescale randomized trials and clinical guidelines have shown a shift from nutritional support to nutritional therapy, with an emphasis on the importance of protein, minerals, vitamins, and trace elements. Nutrition is also important in neurocritically ill patients. Since there are few studies or recommendations with regard to the neurocritical population, the general recommendations for nutritional support should be applied.","PeriodicalId":33246,"journal":{"name":"Journal of Neurocritical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46569396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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