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Acute Acalculous Cholecystitis in Neurological Patients; Clinical Review, Risk Factors, and Possible Mechanism 神经科患者急性无结石性胆囊炎临床回顾、危险因素和可能的机制
Pub Date : 2019-09-19 DOI: 10.32587/jnic.2019.00199
See Won Um, Hak-Cheol Ko, S. Lee, H. Shin, J. Koh
Backgrounds Acute acalculous cholecystitis (AAC) has rarely been reported and has not been fully investigated in patients with severe neurological conditions that can cause changes in consciousness. Delays in diagnosis of AAC may increase the severity of this condition. The aim of this study was to investigate the clinical features and possible mechanisms of AAC in neurological patients. Methods Among the patients with neurological conditions admitted to our hospital between March 2007 and September 2018, the medical records of 52 patients who underwent cholecystectomy after being diagnosed with cholecystitis were reviewed retrospectively. Data regarding age, sex, neurological conditions, Glasgow Coma Scale (GCS) on admission, past medical history, time from admission to the onset of AAC, initial symptoms or signs of AAC, and fasting period were investigated. Results The mean age of the 52 patients (36 male, 16 female) was 67.1±14.4. The mean GCS was 10. The neurological conditions were intracerebral hemorrhage, subarachnoid hemorrhage, subdural hematoma, intraventricular hemorrhage, epidural hematoma, cerebral infarction, cerebral abscess, and hypoxic brain damage. The mean time interval between the onset of AAC and admission was 22.5 days and the mean fasting period was 8.1 days. Conclusion AAC may be a significant complication in patients with neurological conditions. It is important to identify symptoms and signs of AAC, accurately diagnose the AAC, particularly in long-term stay at intensive care unit (ICU), a long period of fasting, state of hypotension or hypoperfusion, high positive end-expiratory pressure (PEEP) ventilation.
背景:急性无结石性胆囊炎(AAC)在伴有严重神经系统疾病的患者中很少被报道,也没有得到充分的研究。延迟诊断AAC可能会增加病情的严重程度。本研究的目的是探讨神经系统患者AAC的临床特征和可能的机制。方法回顾性分析我院2007年3月至2018年9月收治的52例神经系统疾病患者诊断为胆囊炎后行胆囊切除术的病历资料。研究对象的年龄、性别、神经系统状况、入院时格拉斯哥昏迷评分(GCS)、既往病史、入院至AAC发病的时间、AAC的初始症状或体征以及禁食期。结果52例患者(男36例,女16例)平均年龄为67.1±14.4岁。平均GCS为10。神经系统疾病为脑出血、蛛网膜下腔出血、硬膜下血肿、脑室内出血、硬膜外血肿、脑梗死、脑脓肿和缺氧脑损伤。AAC发病至入院的平均时间间隔为22.5天,平均禁食时间为8.1天。结论AAC可能是神经系统疾病患者的重要并发症。鉴别AAC的症状和体征,准确诊断AAC,特别是在重症监护病房(ICU)长期住院、长时间禁食、低血压或低灌注状态、高呼气末正压通气(PEEP)时尤为重要。
{"title":"Acute Acalculous Cholecystitis in Neurological Patients; Clinical Review, Risk Factors, and Possible Mechanism","authors":"See Won Um, Hak-Cheol Ko, S. Lee, H. Shin, J. Koh","doi":"10.32587/jnic.2019.00199","DOIUrl":"https://doi.org/10.32587/jnic.2019.00199","url":null,"abstract":"Backgrounds Acute acalculous cholecystitis (AAC) has rarely been reported and has not been fully investigated in patients with severe neurological conditions that can cause changes in consciousness. Delays in diagnosis of AAC may increase the severity of this condition. The aim of this study was to investigate the clinical features and possible mechanisms of AAC in neurological patients. Methods Among the patients with neurological conditions admitted to our hospital between March 2007 and September 2018, the medical records of 52 patients who underwent cholecystectomy after being diagnosed with cholecystitis were reviewed retrospectively. Data regarding age, sex, neurological conditions, Glasgow Coma Scale (GCS) on admission, past medical history, time from admission to the onset of AAC, initial symptoms or signs of AAC, and fasting period were investigated. Results The mean age of the 52 patients (36 male, 16 female) was 67.1±14.4. The mean GCS was 10. The neurological conditions were intracerebral hemorrhage, subarachnoid hemorrhage, subdural hematoma, intraventricular hemorrhage, epidural hematoma, cerebral infarction, cerebral abscess, and hypoxic brain damage. The mean time interval between the onset of AAC and admission was 22.5 days and the mean fasting period was 8.1 days. Conclusion AAC may be a significant complication in patients with neurological conditions. It is important to identify symptoms and signs of AAC, accurately diagnose the AAC, particularly in long-term stay at intensive care unit (ICU), a long period of fasting, state of hypotension or hypoperfusion, high positive end-expiratory pressure (PEEP) ventilation.","PeriodicalId":356321,"journal":{"name":"Journal of Neurointensive Care","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133925543","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}
引用次数: 0
Safety and Feasibility of Percutaneous Dilatational Tracheostomy Performed by a Neurointensivist Compared with Conventional Surgical Tracheostomy in Neurosurgery Intensive Care Unit 神经外科重症监护室经皮扩张性气管切开术与常规气管切开术的安全性和可行性比较
Pub Date : 2019-09-19 DOI: 10.32587/jnic.2019.00213
J. Kwon, Yong Oh Kim, J. Ryu
A total of 118 patients underwent tracheostomy during the study period. Elective surgery of brain tumor (33.1%) and intracranial hemorrhage (20.3%) were the most common reasons for ICU admission. Prolonged intubation (42.4%) and airway protection or prevent risk of aspiration (25.4%) were the most common reasons for tracheostomy. There was no significant difference in initial success rate of tracheostomy between the two groups (p=0.110). However, procedural time was lengthier in CST than that in PDT (39.0 [30.0–60.0] min vs. 15.0 [11.0–23.0] min, p<0.001). Procedure-induced complications were more common in patients who underwent CST compared to those in patients who underwent PDT (26.3% vs. 11.5%, p=0.039). Although moderate or major bleeding occurred in five patients who underwent CST, only one patient had moderate bleeding in PDT. Especially, there were two respiratory arrests during procedure in CST. In addition, two VAPs and seven wound infections occurred in CST.
在研究期间,共有118例患者接受了气管切开术。择期脑肿瘤手术(33.1%)和颅内出血(20.3%)是ICU住院最常见的原因。延长插管时间(42.4%)和保护气道或防止误吸风险(25.4%)是气管切开术最常见的原因。两组气管切开术初始成功率比较,差异无统计学意义(p=0.110)。然而,CST的手术时间长于PDT (39.0 [30.0-60.0] min vs. 15.0 [11.0-23.0] min, p<0.001)。手术引起的并发症在CST患者中比在PDT患者中更常见(26.3%比11.5%,p=0.039)。虽然5例接受CST的患者出现中度或大出血,但只有1例PDT患者出现中度出血。特别是在CST手术过程中,有两次呼吸骤停。此外,CST中发生2例vap和7例伤口感染。
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引用次数: 3
Delayed Occurrence of CSF Oculorrhea after Mild Blunt Traumatic Head Injury 轻度钝性颅脑损伤后脑脊液漏的延迟发生
Pub Date : 2019-08-22 DOI: 10.32587/JNIC.2019.00143
S. Choi, Sang Pyung Lee, J. Baek, T. Park
hazardous complications including infection of central nervous system(CNS). A 40-year-old male visited with epiphora occurring every morning. He underwent traumatic head injury about a year and a half ago. Intrathecal Gadolinium-Enhanced Magnetic Resonance (MR) Cisternography was performed to diagnose his CSF oculorrhea. The delayed CSF oculorrhea was successfully treatment with continuous lumbar drainage. This case report discusses the diagnosis and treatment of the very rare case of the delayed CSF oculorrhea after mild blunt traumatic head injury.
危险并发症,包括中枢神经系统感染。一名40岁的男性每天早上都会出现顿悟。他大约一年半前头部受了创伤。鞘内钆增强磁共振(MR)脑池造影诊断脑脊液漏。迟发性脑脊液漏经持续腰椎引流治疗成功。本病例报告讨论了罕见的颅脑外伤后迟发性脑脊液漏的诊断和治疗。
{"title":"Delayed Occurrence of CSF Oculorrhea after Mild Blunt Traumatic Head Injury","authors":"S. Choi, Sang Pyung Lee, J. Baek, T. Park","doi":"10.32587/JNIC.2019.00143","DOIUrl":"https://doi.org/10.32587/JNIC.2019.00143","url":null,"abstract":"hazardous complications including infection of central nervous system(CNS). A 40-year-old male visited with epiphora occurring every morning. He underwent traumatic head injury about a year and a half ago. Intrathecal Gadolinium-Enhanced Magnetic Resonance (MR) Cisternography was performed to diagnose his CSF oculorrhea. The delayed CSF oculorrhea was successfully treatment with continuous lumbar drainage. This case report discusses the diagnosis and treatment of the very rare case of the delayed CSF oculorrhea after mild blunt traumatic head injury.","PeriodicalId":356321,"journal":{"name":"Journal of Neurointensive Care","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131455499","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}
引用次数: 0
Change in Nutrition Strategy after Nutritional Support Team Activities for Cerebrovascular Disease Patients in the Intensive Care Unit 重症监护室脑血管病患者营养支持小组活动后营养策略的变化
Pub Date : 2019-08-22 DOI: 10.32587/JNIC.2019.00150
J. Lee, S. Kim, W. Lee, K. Lee, S. Paeng, S. Pyo, Y. Jeong, Kim Ms, Y. Jung
Objective This study was done to introduce a nutrition support strategy and analyze the effect of nutritional support team (NST) activities in a single-center intensive care unit. Methods Between January and June 2017, acute severe cerebrovascular disease (CVA) patients who admitted to the intensive care unit and referred to the NST, were enrolled and assigned to the NST group. Demographics, initial GCS score, needed calorie intake (NCI), type of nutrition, time of switching from parenteral nutrition (PN) to enteral nutrition (EN), NCI satisfaction rate, incidence of feeding intolerance (FI), and clinical outcomes were analyzed, and compared with those in the control group, retrospectively. Results There were 38 patients in the NST group and 39 in the control group. The initial GCS score was 7.03±2.19 in the NST group and 6.82±2.19 in the control group. The average NCI was 1557.9 kcal in the NST group and 1635.9 kcal in the control group. In all patients, the start of PN was possible within 24 hours after admission. The EN start rate was slightly lower in the NST group. EN was initiated earlier in the NST group than in the control group. The NCI satisfaction rate at discharge was higher in the NST group. No statistically significant differences were observed in the rate of good clinical outcomes and incidence of FI between the two groups. Conclusion NST activity enabled the earlier start of EN and achievement of a high NCI satisfaction rate without increasing nutrition support related risks.
目的介绍一种营养支持策略,并分析营养支持小组活动在单中心重症监护病房的效果。方法选取2017年1月至6月入住重症监护室并转介NST的急性重症脑血管病(CVA)患者,并将其分为NST组。回顾性分析人口统计学、初始GCS评分、所需热量摄入(NCI)、营养类型、肠外营养(PN)转肠内营养(EN)时间、NCI满意率、喂养不耐受(FI)发生率及临床结局,并与对照组进行比较。结果NST组38例,对照组39例。NST组初始GCS评分为7.03±2.19,对照组为6.82±2.19。NST组的NCI平均值为1557.9 kcal,对照组为1635.9 kcal。所有患者均可在入院后24小时内开始PN。NST组的EN启动率略低。与对照组相比,NST组的EN开始时间更早。NST组出院时NCI满意率较高。两组患者良好临床转归率和FI发生率无统计学差异。结论NST活性可以使EN更早开始,并在不增加营养支持相关风险的情况下获得较高的NCI满意度。
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引用次数: 0
Endovascular Treatment of Intracranial Aneurysms Associated with Brain Arteriovenous Malformations 颅内动脉瘤伴脑动静脉畸形的血管内治疗
Pub Date : 2019-08-22 DOI: 10.32587/JNIC.2019.00171
Boeun Lee, Jae Whan Lee, K. Park, Dong Joon Kim, B. Kim, Joonho Chung
Objective Brain arteriovenous malformation (AVM) is frequently associated with the presence of intracranial aneurysms, which increase hemorrhage rates resulting in unfavorable outcomes. We report our experience with endovascular treatment (EVT) of intracranial aneurysms associated with AVM. Methods Between March 2010 and February 2017, we treated 274 patients with AVMs. Among them, 27 (9.9%) patients with intracranial aneurysms associated with AVM were treated endovascularly. Clinical and radiographic data for these patients were retrospectively reviewed. Results We treated 32 aneurysms (10 intranidal and 22 proximal aneurysms) in 27 patients. The most frequent presenting symptoms were hemorrhage (59.3%) caused by an AVM nidus in 7 cases and by aneurysm rupture in 9 cases. Of 22 proximal flow-related aneurysms, we performed a simple coiling technique in 16 aneurysms and 6 parent artery occlusions. For 10 intranidal aneurysms, we performed targeted embolization with liquid embolic materials, such as n-Butyl cyanoacrylate or Onyx. There were three procedure-related complications and only one patient suffered transient hemiparesis. Favorable outcome (modified Rankin Scale, mRS 0-2) was achieved in 18 (66.7%) patients and unfavorable outcome (mRS 3-6) in 9 (33.3%) patients, including one death. Conclusion When facing intracranial aneurysms associated with AVMs, EVT might be a useful treatment option for proximal and intranidal aneurysms.
目的脑动静脉畸形(AVM)常与颅内动脉瘤的存在相关,颅内动脉瘤增加出血率,导致不良预后。我们报告我们的经验血管内治疗颅内动脉瘤相关的AVM。方法2010年3月至2017年2月,对274例avm患者进行治疗。其中27例(9.9%)颅内动脉瘤合并AVM行血管内治疗。回顾性分析了这些患者的临床和影像学资料。结果27例患者共32个动脉瘤,其中膜内动脉瘤10个,近端动脉瘤22个。最常见的症状是7例由动静脉瘤病灶引起的出血(59.3%)和9例由动脉瘤破裂引起的出血。在22个近端血流相关动脉瘤中,我们对16个动脉瘤和6个母动脉闭塞进行了简单的卷曲技术。对于10个膜内动脉瘤,我们使用液体栓塞材料(如氰基丙烯酸丁酯或玛瑙)进行靶向栓塞。有三个手术相关的并发症,只有一个病人出现了一过性偏瘫。18例(66.7%)患者预后良好(改良Rankin量表,mRS 0-2), 9例(33.3%)患者预后不良(mRS 3-6),包括1例死亡。结论面对颅内伴动静脉畸形的动脉瘤,EVT可能是治疗近端和膜内动脉瘤的有效选择。
{"title":"Endovascular Treatment of Intracranial Aneurysms Associated with Brain Arteriovenous Malformations","authors":"Boeun Lee, Jae Whan Lee, K. Park, Dong Joon Kim, B. Kim, Joonho Chung","doi":"10.32587/JNIC.2019.00171","DOIUrl":"https://doi.org/10.32587/JNIC.2019.00171","url":null,"abstract":"Objective Brain arteriovenous malformation (AVM) is frequently associated with the presence of intracranial aneurysms, which increase hemorrhage rates resulting in unfavorable outcomes. We report our experience with endovascular treatment (EVT) of intracranial aneurysms associated with AVM. Methods Between March 2010 and February 2017, we treated 274 patients with AVMs. Among them, 27 (9.9%) patients with intracranial aneurysms associated with AVM were treated endovascularly. Clinical and radiographic data for these patients were retrospectively reviewed. Results We treated 32 aneurysms (10 intranidal and 22 proximal aneurysms) in 27 patients. The most frequent presenting symptoms were hemorrhage (59.3%) caused by an AVM nidus in 7 cases and by aneurysm rupture in 9 cases. Of 22 proximal flow-related aneurysms, we performed a simple coiling technique in 16 aneurysms and 6 parent artery occlusions. For 10 intranidal aneurysms, we performed targeted embolization with liquid embolic materials, such as n-Butyl cyanoacrylate or Onyx. There were three procedure-related complications and only one patient suffered transient hemiparesis. Favorable outcome (modified Rankin Scale, mRS 0-2) was achieved in 18 (66.7%) patients and unfavorable outcome (mRS 3-6) in 9 (33.3%) patients, including one death. Conclusion When facing intracranial aneurysms associated with AVMs, EVT might be a useful treatment option for proximal and intranidal aneurysms.","PeriodicalId":356321,"journal":{"name":"Journal of Neurointensive Care","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123710652","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}
引用次数: 0
Internal Carotid Artery Dissection with Traumatic Pseudoaneurysm Formation after Penetrating Head Injury 穿透性颅脑损伤后颈动脉夹层伴外伤性假性动脉瘤形成
Pub Date : 2019-08-22 DOI: 10.32587/JNIC.2019.00164
J. Ham, J. Kim, W. Yoon
Traumatic pseudoaneurysm of the intracranial arteries is a devastating event leading to high mortality. Its prevalence is rare, and associated with blunt or penetrating head injuries. Here, we describe a case of a 46-year-old woman who was transferred to our hospital following a stab-induced head trauma. Owing to multiple assaults by a sharp knife, the patient presented with an injured intracranial internal carotid artery that formed dissecting pseudoaneurysms. Stupor mentality was noted, and brain computed tomography revealed traumatic subarachnoid hemorrhage, and intracerebral hemorrhage in a “knife shape”. Diagnostic angiography showed an active extravasation in the middle cerebral artery and distal internal carotid artery with two pseudoaneurysms. Immediate trapping was planned, and embolization was performed with detachable coils. The patient was transferred to the operation room and emergent decompressive craniectomy with wide durotomy was performed. Unfortunately, the patient expired few days after the operation despite maximal neurocritical care.
外伤性颅内动脉假性动脉瘤是一种致命的疾病,死亡率很高。它的流行是罕见的,并且与钝性或穿透性头部损伤有关。在这里,我们描述了一个46岁的妇女谁被转移到我们医院后刺伤引起的头部创伤。由于多次被锋利的刀袭击,患者表现为颅内颈内动脉受伤,形成夹层性假性动脉瘤。脑ct显示外伤性蛛网膜下腔出血,脑出血呈“刀状”。诊断性血管造影显示大脑中动脉和颈内动脉远端活跃外渗,伴两个假性动脉瘤。计划立即捕获,并使用可拆卸线圈进行栓塞。患者被转移到手术室,并进行了紧急减压颅骨切除术和宽硬膜切开术。不幸的是,尽管进行了最大限度的神经危重症护理,但患者在手术后几天死亡。
{"title":"Internal Carotid Artery Dissection with Traumatic Pseudoaneurysm Formation after Penetrating Head Injury","authors":"J. Ham, J. Kim, W. Yoon","doi":"10.32587/JNIC.2019.00164","DOIUrl":"https://doi.org/10.32587/JNIC.2019.00164","url":null,"abstract":"Traumatic pseudoaneurysm of the intracranial arteries is a devastating event leading to high mortality. Its prevalence is rare, and associated with blunt or penetrating head injuries. Here, we describe a case of a 46-year-old woman who was transferred to our hospital following a stab-induced head trauma. Owing to multiple assaults by a sharp knife, the patient presented with an injured intracranial internal carotid artery that formed dissecting pseudoaneurysms. Stupor mentality was noted, and brain computed tomography revealed traumatic subarachnoid hemorrhage, and intracerebral hemorrhage in a “knife shape”. Diagnostic angiography showed an active extravasation in the middle cerebral artery and distal internal carotid artery with two pseudoaneurysms. Immediate trapping was planned, and embolization was performed with detachable coils. The patient was transferred to the operation room and emergent decompressive craniectomy with wide durotomy was performed. Unfortunately, the patient expired few days after the operation despite maximal neurocritical care.","PeriodicalId":356321,"journal":{"name":"Journal of Neurointensive Care","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125667065","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}
引用次数: 0
Endovascular Treatment of Ruptured Dissecting Aneurysms on the P2-3 Segment of the Posterior Cerebral Artery: A Report of Two Cases 脑后动脉P2-3段破裂夹层动脉瘤的血管内治疗(附2例报告)
Pub Date : 2019-08-22 DOI: 10.32587/JNIC.2019.00157
Seonah Choi, Joonho Chung
Intracranial ruptured dissecting aneurysms can have fatal outcomes. Among them, posterior cerebral artery dissecting aneurysm with hemorrhage is uncommon but usually fatal due to its deep location and proximity to surrounding critical structures. Most previously published reports on this type of aneurysm have concluded that the neurologic outcome can be improved with the use of certain surgical or endovascular approaches. However, in severe cases with a poor initial clinical status, patient improvement should not be expected. We report two cases of P2-3 segment ruptured dissecting aneurysms that were treated by external ventricular drainage for control of increased intracranial pressure followed by one-stage endovascular treatment for the aneurysm.
颅内夹层动脉瘤破裂可能导致致命的后果。其中,脑后动脉夹层动脉瘤合并出血并不常见,但由于其位置较深且邻近周围关键结构,通常是致命的。大多数先前发表的关于这类动脉瘤的报告都得出结论,使用某些手术或血管内入路可以改善神经系统预后。然而,在初始临床状况较差的严重病例中,不应期望患者改善。我们报告两例P2-3节段破裂的夹层动脉瘤,采用脑室外引流术控制颅内压升高,然后进行一期血管内治疗。
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引用次数: 1
Guidelines for Cauda Equina Syndrome Management 马尾综合征治疗指南
Pub Date : 2019-04-30 DOI: 10.32587/JNIC.2019.00136
Junseok W. Hur, Dong-Hyuk Park, Jang-Bo Lee, Tai-Hyoung Cho, J. Park
ever, proper diagnosis is often confused. There are some clinical check points; bilateral radiculopathy, impaired perineal sensation, impaired anal tone, and urinary retention. In addition, magnetic resonance image should match the clinical symptom. With these clinical and radiographic evidences, we can classify CES as CES suspected or suspicious (CESS), incomplete CES (CESI), and CES with neurogenic retention of urine (CESR). All these situations may need surgery, however, the timing of surgery and neurologic outcomes are various. Herein we prescribe the guideline for proper treatment strategy of CES.
然而,正确的诊断往往是混乱的。有一些临床检查点;双侧神经根病,会阴部感觉受损,肛门张力受损,尿潴留。此外,磁共振图像应与临床症状相匹配。根据这些临床和影像学证据,我们可以将CES分为疑似或可疑CES (CESS)、不完全CES (CESI)和神经源性尿潴留CES (CESR)。所有这些情况都可能需要手术,然而,手术的时机和神经系统的结果是不同的。在此,我们提出了正确的治疗策略指南。
{"title":"Guidelines for Cauda Equina Syndrome Management","authors":"Junseok W. Hur, Dong-Hyuk Park, Jang-Bo Lee, Tai-Hyoung Cho, J. Park","doi":"10.32587/JNIC.2019.00136","DOIUrl":"https://doi.org/10.32587/JNIC.2019.00136","url":null,"abstract":"ever, proper diagnosis is often confused. There are some clinical check points; bilateral radiculopathy, impaired perineal sensation, impaired anal tone, and urinary retention. In addition, magnetic resonance image should match the clinical symptom. With these clinical and radiographic evidences, we can classify CES as CES suspected or suspicious (CESS), incomplete CES (CESI), and CES with neurogenic retention of urine (CESR). All these situations may need surgery, however, the timing of surgery and neurologic outcomes are various. Herein we prescribe the guideline for proper treatment strategy of CES.","PeriodicalId":356321,"journal":{"name":"Journal of Neurointensive Care","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130166583","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}
引用次数: 7
Prognostic Value of Optic Nerve Sheath Diameter in Patients after Extracorporeal Cardiopulmonary Resuscitation 体外心肺复苏后视神经鞘直径对患者预后的价值
Pub Date : 2019-04-30 DOI: 10.32587/JNIC.2019.00108
Young-Jin Kim, J. Ryu, Yong Oh Kim, Y. Cho, Jeong Hoon Yang, Sangkil Lee, J. Baek
Ji Sun Baek Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Neurology, ChungBuk National University Hospital, Cheongju, Korea Department of Ophthalmology, Konyang University, Kim’s Eye Hospital, Myung-Gok Eye Research Institute, Seoul, Korea
成均馆大学医学院三星医疗中心神经外科、成均馆大学医学院三星医疗中心韩国重症医学科、成均馆大学医学院三星医疗中心韩国胸心血管外科、成均馆大学医学院三星医疗中心韩国心脏科、成均馆大学医学院三星医疗中心韩国心脏科、成均馆大学医学院首尔三星医疗中心医学部、清州忠北大学医院韩国神经内科、建阳大学韩国眼科科、首尔明谷眼科研究所金氏眼科医院
{"title":"Prognostic Value of Optic Nerve Sheath Diameter in Patients after Extracorporeal Cardiopulmonary Resuscitation","authors":"Young-Jin Kim, J. Ryu, Yong Oh Kim, Y. Cho, Jeong Hoon Yang, Sangkil Lee, J. Baek","doi":"10.32587/JNIC.2019.00108","DOIUrl":"https://doi.org/10.32587/JNIC.2019.00108","url":null,"abstract":"Ji Sun Baek Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Neurology, ChungBuk National University Hospital, Cheongju, Korea Department of Ophthalmology, Konyang University, Kim’s Eye Hospital, Myung-Gok Eye Research Institute, Seoul, Korea","PeriodicalId":356321,"journal":{"name":"Journal of Neurointensive Care","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122372110","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}
引用次数: 1
Neurointensive Care for Spinal Injuries ; Perspective on Its Role in Early Stage 脊髓损伤的神经重症监护;对其早期作用的透视
Pub Date : 2019-04-30 DOI: 10.32587/JNIC.2019.00129
W. Kwon, Dong-Hyuk Park, Jong-Keon Oh, J. Kim, H. Roh, H. Moon, Joo-Han Kim, Youn-Kwan Park
Woo-Keun Kwon, Dong-Hyuk Park, Jong-Keon Oh, Jang Hun Kim, Haewon Roh, Hong Joo Moon, Joo Han Kim, Youn-Kwan Park Department of Neurosurgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea Department of Neurosurgery, Korea University Medical Center, Anam Hospital, Korea University College of Medicine, Seoul, Korea Focused Training Center for Trauma, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea Department of Orthopedic Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea Department of Neurosurgery, Korean Armed Forces Capital Hospital, Seongnam, Korea
权佑根、朴东赫、吴钟健、金张勋、卢海源、文洪柱、金珠韩、朴允宽、首尔高丽大学医学院高丽大学九老医院神经外科、首尔高丽大学医学院高丽大学医疗中心安岩医院韩国神经外科、首尔高丽大学医学院高丽大学九老医院韩国创伤重点培训中心、首尔高丽大学医学院首尔高丽大学医学院高丽大学九老医院韩国整形外科,城南韩国军首都医院韩国神经外科
{"title":"Neurointensive Care for Spinal Injuries ; Perspective on Its Role in Early Stage","authors":"W. Kwon, Dong-Hyuk Park, Jong-Keon Oh, J. Kim, H. Roh, H. Moon, Joo-Han Kim, Youn-Kwan Park","doi":"10.32587/JNIC.2019.00129","DOIUrl":"https://doi.org/10.32587/JNIC.2019.00129","url":null,"abstract":"Woo-Keun Kwon, Dong-Hyuk Park, Jong-Keon Oh, Jang Hun Kim, Haewon Roh, Hong Joo Moon, Joo Han Kim, Youn-Kwan Park Department of Neurosurgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea Department of Neurosurgery, Korea University Medical Center, Anam Hospital, Korea University College of Medicine, Seoul, Korea Focused Training Center for Trauma, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea Department of Orthopedic Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea Department of Neurosurgery, Korean Armed Forces Capital Hospital, Seongnam, Korea","PeriodicalId":356321,"journal":{"name":"Journal of Neurointensive Care","volume":"60 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126528884","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}
引用次数: 0
期刊
Journal of Neurointensive Care
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