Intensive care in neurology and neurosurgery : pathophysiological basis for the management of acute cerebral injury / Daniel Agustin Godoy.

Includes bibliographical references.

Print version record.

Title Page; Colophon; Table of Contents; Prologue; Preface; Section 1. Introduction to Neuroinjury; 1 Neuroscience Critical Care: Two Experts' Point of View; 1.1 History, Organization, and Vision for the Future: Prof. Mirski's Point of View; 1.2 NICU Organization: Past, Present and Future: Prof. Robertson's Point of View; References; 2 Basic Anatomy Applied to the Interpretation of Axial Tomography of the Brain in Emergency Medicine; 2.1 Introduction; 2.2 Development; 2.3 Key Concepts; 2.4 Appendix: Images; References; General References.

3 Physiological Basis for the Correct Interpretation of Different Situations in Acute Cerebral Injury3.1 Functional and Structural Organization of the Nervous System; 3.2 The Blood-Brain Barrier (BBB); 3.3 Cerebrospinal Fluid (CSF); 3.4 Aquaporins (AQP); 3.5 Intracranial Pressure; 3.6 Cerebral Volume/Pressure Curve (V/P). Cerebral Compliance; 3.7 Intracranial Pressure Curve; 3.8 Cerebral Oxygen Metabolism; 3.9 Cerebral Blood Flow (CBF); 3.10 Oxygen Tissue Pressure (ptiO2); 3.11 Cerebral Glucose Metabolism; 3.12 Cerebral Temperature; 3.13 Brain-systemic Temperature Gradient.

3.14 Concept of Primary and Secondary InjuryGeneral References; 4 Examination of the Critically Ill Neurological Patient; 4.1 Clinical Evaluation (or Examination) of the Critically Ill Neurological Patient; 4.2 General Examination; 4.3 Comprehensive Neurological Examination; 4.4 Routine Investigations of the Neurocritical Patient ; 4.5 Focused Neurological Examination of Selected Topics ; References; General References; 5 Evaluation Scales in Neurocritically Ill Patients; 5.1 Objectives; 5.2 Introduction; 5.3 Evaluation in the Acute Phase; 5.4 Imaging-based Assessment Scales.

5.5 Scale of Evolution, Evaluation of Consciousness in Advanced Stages of Brain Injury Outcome ScalesGeneral References; Section 2. Neuromonitoring; 6 Neuroimage Monitoring in the Management of Neurocritical Care Patients; 6.1 Introduction; 6.2 CT in Head-injured Patients; 6.3 CT in Patients With Cerebrovascular Hemorrhagic Disease; 6.4 CT in the Diagnosis of Acute Ischemic Cerebrovascular Diseases ; 6.5 Conclusions; References; 7 Intracranial Pressure Monitoring. Acute Cerebral Injury: the First 48 Hours; 7.1 Intracranial Pressure; 7.2 Techniques for Monitoring Intracranial Pressure.

7.3 The ICP Waveform7.4 Elevated Intracranial Pressure and Pressure Waves; 7.5 Cerebral Perfusion Pressure; 7.6 Cerebral Autoregulation; 7.7 Indications for ICP Monitoring; 7.8 Conclusions; References; 8 Update on Brain Tissue Oxygen Monitoring in TBI and Other Acute Cerebral Disorders; 8.1 Introduction; 8.2 Approaches to Monitoring Cerebral Oxygenation; 8.3 Hyperemia and Arterial pCO2 ; 8.4 Approaches to Treatment; 8.5 Early Detection and Treatment of Ischemia; 8.6 Suggestions and Limitations; 8.7 Conclusions; References.

Annotation Neuromonitoring is a tool of the trade in intensive care, and should incorporate cutting-edge technology with patience, repeated clinical observation, and careful identification of neuroworsening. The aim of the book is to be of practical use, and to assist the clinical practice of the busy physician. The clinical examination is the introductory section of the book, and an abundance of technology, with specific emphasis on the importance of intracranial pressure, follows. Since the patient with an injured brain can survive only if other organs and systems (such as the lungs, the acid-base equilibrium, etc.) are preserved, a section of the book covers the interactions between the affected brain and other organs. The intracranial pressure measurement starts (or unfortunately ends) with a well-maintained catheter, which becomes vital when the drainage of hydrocephalus is involved. Dealing with patients with severe brain damage has plenty of ethical implications, up to and including the problems related to brain death and organ donation.

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