Neurocritical Care Third Edition What Do I Do Now

Neurocritical Care is a primer for physicians seeing patients in the neurointensive care unit, with a specific focus on interventions in acute neurologic disorders. Neurocritical care in daily practice involves management of deteriorating patients, treatment of complications, along with end-of-life care assisting families with problematic decisions. A great number of pertinent topics can be found in this case-based book.

Written with a conversational tone and using a case-based approach, the emphasis is on how to oversee comparatively common clinical problems emergently. The goal is to provide readily implementable solutions and to challenge the reader with making acute decisions in common patient examples. The brief discussions boil down to the essentials and bare necessities of neurocritical care. This third edition has over twenty new cases with new coverage on contemporary issues. Expansion of previously discussed topics include additional complications in traumatic brain injury and subarachnoid hemorrhage, complications after craniotomy, elusive rapid progressive brain disease, “wake-up stroke” immune checkpoint inhibitor and CAR-T cell therapy complications, complications of LVAD, and early prognostication and communication conundrums. An easy read for new physicians, residents, and medical students, it provides practical advice from the authors’ seasoned experiences.

• Provides instruction on all major neurologic emergencies in a nutshell
• Part of the “What Do I Do Now?” series which utilizes a case-based approach and a conversational tone
• Both an engaging collection of thought-provoking cases and a self-assessment tool

CONTENTS

SECTION 1: ACUTE INTERVENTIONS
1.EXPANDING LOBAR CEREBRAL HEMORRHAGE
2. REVERSING AND RESTARTING ANTICOAGULATION IN CEREBRAL HEMORRHAGE
3. THE VERY FIRST PRIORITIES IN TRAUMATIC BRAIN INJURY
4. ACUTE SUBDURAL HEMATOMA WITH A TAXING POST OPERATIVE COURSE
5. CRANIECTOMY’S TRIAD OF COMPLICATIONS
6. GRAPPLING WITH ACUTE BACTERIAL MENINGITIS
7. SORTING OUT AND TREATING ACUTE ENCEPHALITIS
8. THE PRESENTING FEATURES OF AUTOIMMUNE ENCEPHALITIS
9. ESCALATING DYSPNEA IN ACUTE NEUROMUSCULAR DISEASE
10. LIFE-THREATENING COMPLICATIONS OF INTRAVENOUS THROMBOLYSIS
11. WHEN TO RETRIEVE A CLOT IN ACUTE STROKE
12. “WAKE UP”‘ MAJOR STROKE
13. RECOGNIZING AN ACUTE EMBOLUS TO THE BASILAR ARTERY
14.TIMING OF HEMICRANIECTOMY IN SWOLLEN ISCHEMIC STROKE
15. WORSENING CEREBRAL VENOUS THROMBOSIS DESPITE ANTICOAGULATION
16. ANEURYSMAL SUBARACHNOID HEMORRHAGE: FROM GOOD TO BAD GRADE
17. DELAYED CEREBRAL VASOSPASM IN ANEURYSMAL SUBARACHNOID HEMORRHAGE
18. NONANEURYSMAL SUBARACHNOID HEMORRHAGE TURNING ANEURYSMAL
19. OPTIONS IN ACUTE SPINAL CORD COMPRESSION DUE TO CANCER
20. UNANTICIPATED PARAPLEGIA AFTER AORTIC REPAIR
21. WHEN STATUS EPILEPTICUS CANNOT BE CONTROLLED
22. WHEN BRAIN METASTASIS BECOME A NEUROCRITICAL EMERGENCY
23. THE SURGICAL URGENCY WITH PITUITARY APOPLEXY
24. ECLAMPSIA AND ITS NEUROLOGIC CONSEQUENCES
25. TARGETED TEMPERATURE MANAGEMENT AFTER CARDIOPULMONARY RESUSCITATION
26. SURVIVING CARDIAC ARREST BUT DISABLING TWITCHES
27. HYPERTENSIVE EMERGENCY AND BRAIN EDEMA
28. THE ELUSIVE RAPID PROGRESSIVE BRAIN DISEASE
29. IMMUNE CHECKPOINT INHIBITOR AND NEUROMUSCULAR DISEASE
30. NEUROTOXICITY OF CAR-T CELL THERAPY
31. FAILURE TO AWAKEN AFTER SURGERY
32. STUPOR AFTER BRAIN SURGERY
33. WHEN ANTIEPILEPTIC DRUGS MAY CAUSE HARM
34. INTRACRANIAL HEMORRHAGE AND LVAD
SECTION 2: THE BASICS OF BRAIN MONITORING
35. THE CHOICE BETWEEN SPOT AND CONTINUOUS ELECTROENCEPHALOGRAPHY
36. WHEN TO PLACE AN INTRACRANIAL PRESSURE MONITOR
SECTION 3: CALLS, PAGES, AND OTHER ALARMS
37. ALERT WITH A FIXED AND DILATED PUPIL
38. SORTING THROUGH DELIRIUM
39. ANTIBIOTIC-ASSOCIATED TOXIC ENCEPHALOPATHY IN SEPSIS
40. ALCOHOL WITHDRAWAL WITH EXTREME AGITATION
41. ALCOHOL RELATED ACUTE NEUROLOGIC COMPLICATIONS
42. SUDDEN HYPOTENSION AND FEVER SPIKE
43. WHEN BLOOD PRESSURE IS TOO HIGH
44. ACUTE WHITE-OUT ON CHEST X-RAY
45. STORMING WITH SWEATING, FEVER, AND RIGID POSTURING
46. THE COMMON CARDIAC ARRHYTMIAS
47. DYSAUTONOMIA IN GUILLAIN-BARRÉ SYNDROME
48. DIFFICULT VENTILATOR WEANING IN MYASTHENIA GRAVIS
49. DECREASING SERUM SODIUM
50. INCREASING SERUM SODIUM
51. RISING AMMONIA IN LIVER CIRRHOSIS
SECTION 4: PRINCIPLES OF PROGNOSTICATION
52. PROGNOSTICATION AFTER SEVERE TRAUMATIC BRAIN INJURY
53. PROGNOSTICATION AFTER ACUTE ISCHEMIC STROKE AND CEREBRAL HEMORRHAGE
54. PROGNOSTICATION AFTER CARDIOPULMONARY RESUSCITATION
SECTION 5: LONG-TERM SUPPORT, END OF LIFE CARE, AND PALLIATION
55. DECISIONS IN PERSISTENT COMATOSE STATES
56. WHEN WITHDRAWAL OF LIFE-SUSTAINING TREATMENT IS CONSIDERED
57. BRAIN DEATH DETERMINATION: SLIP -UPS AND OTHER MISREADINGS
58. WHEN TO MENTION ORGAN DONATION
SECTION 6: THE OTHER SIDE OF NEUROCRITICAL CARE: COMMUNICATION CONUNDRUMS
59. PATIENTS COMING IN AND GOING OUT
60. WHEN FAMILIES DO NOT AGREE WITH OUR APPROACH AND CARE