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1. Fatal Cerebral Edema in a Child With COVID-19

Author

Kim, Michael G, Stein, Alan A, Overby, Philip, Kleinman, George, Nuoman, Rolla, Gulko, Edwin, Al-Mufti, Fawaz, Pisapia, Jared M, and Muh, Carrie R

Subjects
Paediatrics, Biomedical and Clinical Sciences, Neurosciences, Anti-Bacterial Agents, Anticonvulsants, Brain Edema, COVID-19, Child, Diagnosis, Differential, Drug Therapy, Combination, Electroencephalography, Encephalitis, Fatal Outcome, Humans, Hydroxychloroquine, Intracranial Hypertension, Male, Symptom Assessment, Systemic Inflammatory Response Syndrome, Tomography, X-Ray Computed, COVID-19 Drug Treatment, Pediatric, Coronavirus, SARS-CoV-2, Pediatric multisystem inflammatory syndrome, Paediatrics and Reproductive Medicine, Neurology & Neurosurgery
Published
2021

3. Significant Mortality Associated With COVID-19 and Comorbid Cerebrovascular Disease: A Quantitative Systematic Review

Author

Sursal, Tolga, Gandhi, Chirag D., Clare, Kevin, Feldstein, Eric, Frid, Ilya, Kefina, Martin, Galluzzo, Daniela, Kamal, Haris, Nuoman, Rolla, Amuluru, Krishna, Muh, Carrie R., Pisapia, Jared M., Gulko, Edwin, Overby, Philip, Chandy, Dipak, Etienne, Mill, Kurian, Christeena, Kaur, Gurmeen, Dakay, Katarina, AlHamid, May, Al-Jehani, Hosam, Mayer, Stephan A., and Al-Mufti, Fawaz

Published
2023
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15. Neuroendovascular Surgery Applications in Craniocervical Trauma

Author

Kim, Michael, primary, Subah, Galadu, additional, Cooper, Jared, additional, Fortunato, Michael, additional, Nolan, Bridget, additional, Bowers, Christian, additional, Prabhakaran, Kartik, additional, Nuoman, Rolla, additional, Amuluru, Krishna, additional, Soldozy, Sauson, additional, Das, Alvin, additional, Regenhardt, Robert W., additional, Izzy, Saef, additional, Gandhi, Chirag, additional, and Al-Mufti, Fawaz, additional

Published
2023
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16. Prediction of Mortality After Convulsive Status Epilepticus: The Status Epilepticus M3A2S2H Score

Author

Al-Mufti, Fawaz, primary, Patel, Smit D., additional, Ogulnick, Jonathan, additional, Subah, Galadu, additional, Nolan, Bridget, additional, Uddin, Anaz, additional, Blowes, Leah, additional, Bloomfield, Jessica, additional, Raghavendran, Keshav, additional, Marikunte, Sanjana, additional, Feldstein, Eric, additional, Nuoman, Rolla, additional, Rosenberg, Jon, additional, Bauerschmidt, Andrew, additional, Overby, Philip, additional, Ramani, Venkat, additional, Wolf, Steven M., additional, Milligan, Tracey, additional, Holmes, Manisha, additional, Gandhi, Chirag D., additional, Etienne, Mill, additional, and Mayer, Stephan A., additional

Published
2023
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18. Acute ischemic strokes in patients with developmental disabilities: A cross-sectional analysis.

Author

Lui, Aiden, Feldstein, Eric, Clare, Kevin, Dicpinigaitis, Alis J, Reddy, Medha, Khan, Farzana, Semaan, Rosa, Galluzzo, Daniela, Shapiro, Steve, Kamal, Haris, Yaghi, Shadi, Pisapia, Jared, Muh, Carrie, Nuoman, Rolla, Overby, Philip, Etienne, Mill, Chong, Ji, Mayer, Stephan, Gandhi, Chirag D, and Al-Mufti, Fawaz

Subjects
STROKE patients, DEVELOPMENTAL disabilities, TISSUE plasminogen activator, CHILDREN with developmental disabilities, CROSS-sectional method, ISCHEMIC stroke, APHASIC persons
Abstract

Objective: Patients with developmental disabilities (DD) are frequently excluded from acute ischemic stroke (AIS) randomized control trials. We sought to evaluate the impact of having DD on this patient cohort Methods: The National Inpatient Sample was analyzed to explore the impact of AIS and treatment on discharge dispositions in patients with DD. Clinical characteristics, treatments, and outcomes were compared to fully-abled patients with AIS. Results: 1,605,723 patients with AIS were identified from 2010–2019, of whom 4094 (0.30%) had a DD. AIS patients with DD were younger (60.31 vs 70.93 years, p < 0.01), less likely to be Caucasian (66.37%vs 68.09%, p = 0.01), and had higher AIS severity (0.63 vs 0.58, p < 0.01). Tissue plasminogen activator (tPA) was administered in 99,739 (6.2%) fully-abled patients and 196 (4.79%) of patients with DD (p < 0.01). Endovascular thrombectomy (EVT) was performed in 21,066 (1.31%) of fully-abled patients and 35 (0.85%) of patients with DD (p < 0.01). The presence of developmental disabilities were predictive of lower rates of tPA (OR:0.71,CI:0.56–0.87,p < 0.01) and EVT (OR:0.24,CI:0.16–0.36,p < 0.01). In a propensity score-matched cohort of all AIS patients who underwent EVT, there was no difference in functional outcome (p = 0.41), in-hospital mortality (0.10), and LOS (p = 0.79). Conclusion: AIS patients with DD were less likely to receive tPA and EVT compared to fully-abled patients. Individuals with DD had higher mortality and worse discharge disposition. There was no significant difference in post-EVT outcomes between fully-abled patients and patients with developmental disabilities. In the absence of prospective clinical trials, population based cross-sectional analyses such as the present study provide valuable clinical insight. [ABSTRACT FROM AUTHOR]

Published
2023
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19. Abstract Number ‐ 2: Intravenous Thrombolysis for Pediatric Ischemic Stroke: Twenty Years of Population‐Level Data in the United States

Author

Dicpinigaitis, Alis J, primary, Shapiro, Steven D, additional, Nuoman, Rolla, additional, Kamal, Haris, additional, Overby, Philip, additional, Kaur, Gurmeen, additional, Chong, Ji Y, additional, Fifi, Johanna T, additional, Dangayach, Neha, additional, Miller, Eliza C, additional, Yaghi, Shadi, additional, and Al‐Mufti, Fawaz, additional

Published
2023
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20. Incidence, Characteristics, and Outcomes of Pediatric Stroke Patients with Sickle Cell Disease

Author

Graifman, Gillian, primary, Rosenberg, Ashley, additional, Vazquez, Sima, additional, Ng, Helen, additional, Subah, Galadu, additional, Pisapia, Jared M., additional, Mohan, Avinash, additional, Muh, Carrie R., additional, Jacobson, Ronald, additional, Overby, Philip, additional, Wolf, Steven, additional, Al-Mufti, Fawaz, additional, and Nuoman, Rolla, additional

Published
2023
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21. Significant Mortality Associated With COVID-19 and Comorbid Cerebrovascular Disease

Author

Sursal, Tolga, primary, Gandhi, Chirag D., additional, Clare, Kevin, additional, Feldstein, Eric, additional, Frid, Ilya, additional, Kefina, Martin, additional, Galluzzo, Daniela, additional, Kamal, Haris, additional, Nuoman, Rolla, additional, Amuluru, Krishna, additional, Muh, Carrie R., additional, Pisapia, Jared M., additional, Gulko, Edwin, additional, Overby, Philip, additional, Chandy, Dipak, additional, Etienne, Mill, additional, Kurian, Christeena, additional, Kaur, Gurmeen, additional, Dakay, Katarina, additional, AlHamid, May, additional, Al-Jehani, Hosam, additional, Mayer, Stephan A., additional, and Al-Mufti, Fawaz, additional

Published
2022
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22. Intravenous thrombolysis for treatment of pediatric acute ischemic stroke: Analysis of 20 years of population-level data in the United States

Author

Dicpinigaitis, Alis J, primary, Shapiro, Steven D, additional, Nuoman, Rolla, additional, Kamal, Haris, additional, Overby, Philip, additional, Kaur, Gurmeen, additional, Chong, Ji Y, additional, Fifi, Johanna T, additional, Dangayach, Neha, additional, Miller, Eliza C, additional, Yaghi, Shadi, additional, and Al-Mufti, Fawaz, additional

Published
2022
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24. Acute ischemic strokes in patients with developmental disabilities: A cross-sectional analysis

Author

Lui, Aiden, primary, Feldstein, Eric, additional, Clare, Kevin, additional, Dicpinigaitis, Alis J, additional, Reddy, Medha, additional, Khan, Farzana, additional, Semaan, Rosa, additional, Galluzzo, Daniela, additional, Shapiro, Steve, additional, Kamal, Haris, additional, Yaghi, Shadi, additional, Pisapia, Jared, additional, Muh, Carrie, additional, Nuoman, Rolla, additional, Overby, Philip, additional, Etienne, Mill, additional, Chong, Ji, additional, Mayer, Stephan, additional, Gandhi, Chirag D, additional, and Al-Mufti, Fawaz, additional

Published
2022
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25. Intravenous thrombolysis for treatment of pediatric acute ischemic stroke: Analysis of 20 years of population-level data in the United States.

Author

Dicpinigaitis, Alis J, Shapiro, Steven D, Nuoman, Rolla, Kamal, Haris, Overby, Philip, Kaur, Gurmeen, Chong, Ji Y, Fifi, Johanna T, Dangayach, Neha, Miller, Eliza C, Yaghi, Shadi, and Al-Mufti, Fawaz

Subjects
ISCHEMIC stroke, PEDIATRIC therapy, STATISTICAL sampling, INTRACRANIAL hemorrhage, THROMBOLYTIC therapy
Abstract

Background and Aims: Although intravenous thrombolysis (IVT) represents standard-of-care treatment for acute ischemic stroke (AIS) in eligible adult patients, definitive evidence-based guidelines and randomized clinical trial data evaluating its safety and efficacy in the pediatric population remain absent from the literature. We aimed to evaluate the utilization and outcomes of IVT for the treatment of pediatric AIS using a large national registry. Methods: Weighted hospitalizations for pediatric (<18 years of age) AIS patients were identified in the National Inpatient Sample during the period of 2001 to 2019. Complex sample statistical methods were performed to assess unadjusted and adjusted outcomes in patients treated with IVT or other medical management. Results: Among 13,901 pediatric AIS patients, 270 (1.9%) were treated with IVT monotherapy (median age 12.8 years). IVT-treated patients developed any intracranial hemorrhage (ICH) at a rate of 5.6% (n = 15), and 71.9% (n = 194) experienced favorable functional outcomes at discharge (to home or to acute rehabilitation). Following propensity-score adjustment for age, acute stroke severity, infarct location, and etiological/comorbid conditions, IVT was not associated with an increased risk of any ICH (5.6% vs 5.4%, p = 0.931; adjusted odds ratio (aOR) = 1.01, 95% confidence interval (CI) = 0.48–2.14, p = 0.971), nor with favorable functional outcome (71.9% vs 74.5%, p = 0.489; aOR = 0.88, 95% CI = 0.60–1.29, p = 0.511) in comparison with other medical therapy. Conclusions: Twenty years of population-level data in the United States demonstrate that pediatric AIS patients treated with IVT experienced high rates of favorable outcomes without an increased risk of hemorrhagic transformation. [ABSTRACT FROM AUTHOR]

Published
2023
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26. Endovascular Thrombectomy for Pediatric Acute Ischemic Stroke

Author

Dicpinigaitis, Alis J., primary, Gandhi, Chirag D., additional, Pisapia, Jared, additional, Muh, Carrie R., additional, Cooper, Jared B., additional, Tobias, Michael, additional, Mohan, Avinash, additional, Nuoman, Rolla, additional, Overby, Philip, additional, Santarelli, Justin, additional, Hanft, Simon, additional, Bowers, Christian, additional, Yaghi, Shadi, additional, Mayer, Stephan A., additional, and Al-Mufti, Fawaz, additional

Published
2022
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27. sj-docx-1-ine-10.1177_15910199221110327 - Supplemental material for Acute ischemic strokes in patients with developmental disabilities: A cross-sectional analysis

Author

Lui, Aiden, Feldstein, Eric, Clare, Kevin, Dicpinigaitis, Alis J, Reddy, Medha, Khan, Farzana, Semaan, Rosa, Galluzzo, Daniela, Shapiro, Steve, Kamal, Haris, Yaghi, Shadi, Pisapia, Jared, Muh, Carrie, Nuoman, Rolla, Overby, Philip, Etienne, Mill, Chong, Ji, Mayer, Stephan, Gandhi, Chirag D, and Al-Mufti, Fawaz

Subjects
FOS: Clinical medicine, 110904 Neurology and Neuromuscular Diseases, Neuroscience
Abstract

Supplemental material, sj-docx-1-ine-10.1177_15910199221110327 for Acute ischemic strokes in patients with developmental disabilities: A cross-sectional analysis by Aiden Lui, Eric Feldstein, Kevin Clare, Alis J Dicpinigaitis, Medha Reddy, Farzana Khan, Rosa Semaan, Daniela Galluzzo, Steve Shapiro, Haris Kamal, Shadi Yaghi, Jared Pisapia, Carrie Muh, Rolla Nuoman, Philip Overby, Mill Etienne, Ji Chong, Stephan Mayer, Chirag D Gandhi and Fawaz Al-Mufti in Interventional Neuroradiology

Published
2022
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28. Bihemispheric ischemic strokes in patients with COVID-19

Author

Al-Mufti, Fawaz, primary, Kurian, Christeena, additional, Mayer, Stephan, additional, Kaur, Gurmeen, additional, Sahni, Ramandeep, additional, Feldstein, Eric, additional, Samaan, Mena, additional, Viswanathan, Divya, additional, Sami, Tamarah, additional, Ali, SyedFaizan, additional, Al-Shammari, Hussein, additional, Bloomfield, Jessica, additional, Bravo, Michelle, additional, Nuoman, Rolla, additional, Gulko, Edwin, additional, and Gandhi, ChiragD, additional

Published
2022
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29. Bihemispheric ischemic strokes in patients with COVID-19

Author

Kurian, Christeena, Mayer, Stephan, Kaur, Gurmeen, Sahni, Ramandeep, Samaan, Mena, Viswanathan, Divya, Sami, Tamarah, Ali, Syed, Al-Shammari, Hussein, Bloomfield, Jessica, Bravo, Michelle, Nuoman, Rolla, Gulko, Edwin, Gandhi, Chirag, and Al-Mufti, Fawaz

Published
2021
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30. Obstructive sleep apnea confers lower mortality risk in acute ischemic stroke patients treated with endovascular thrombectomy: National Inpatient Sample analysis 2010–2018

Author

Lapow, Justin M, primary, Dicpinigaitis, Alis J, additional, Pammal, Rajkumar S, additional, Coghill, Griffin A, additional, Rechester, Osher, additional, Feldstein, Eric, additional, Nuoman, Rolla, additional, Maselli, Kristina, additional, Kodi, Shyla, additional, Bauerschmidt, Andrew, additional, Rosenberg, Jon B, additional, Yaghi, Shadi, additional, Kaur, Gurmeen, additional, Kurian, Christeen, additional, Chong, Ji Y, additional, Mayer, Stephan A, additional, Gandhi, Chirag D, additional, and Al-Mufti, Fawaz, additional

Published
2021
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31. Obstructive sleep apnea confers lower mortality risk in acute ischemic stroke patients treated with endovascular thrombectomy: National Inpatient Sample analysis 2010-2018.

Author

Lapow, Justin M., Dicpinigaitis, Alis J., Pammal, Rajkumar S., Coghill, Griffin A., Rechester, Osher, Feldstein, Eric, Nuoman, Rolla, Maselli, Kristina, Kodi, Shyla, Bauerschmidt, Andrew, Rosenberg, Jon B., Yaghi, Shadi, Kaur, Gurmeen, Kurian, Christeen, Ji Y. Chong, Mayer, Stephan A., Gandhi, Chirag D., and Al-Mufti, Fawaz

Subjects
OBESITY, HYPERTENSION, ISCHEMIC stroke, MULTIPLE regression analysis, AGE distribution, INTRACRANIAL hemorrhage, RACE, ATRIAL fibrillation, DIABETES, HOSPITAL mortality, COMPARATIVE studies, SEX distribution, THROMBECTOMY, SLEEP apnea syndromes, DESCRIPTIVE statistics, ENDOVASCULAR surgery
Abstract

Background Obstructive sleep apnea (OSA) portends increased morbidity and mortality following acute ischemic stroke (AIS). Evaluation of OSA in the setting of AIS treated with endovascular mechanical thrombectomy (MT) has not yet been evaluated in the literature. Methods The National Inpatient Sample from 2010 to 2018 was utilized to identify adult AIS patients treated with MT. Those with and without OSA were compared for clinical characteristics, complications, and discharge disposition. Multivariable logistic regression analysis and propensity score adjustment (PA) were employed to evaluate independent associations between OSA and clinical outcome. Results Among 101 093 AIS patients treated with MT, 6412 (6%) had OSA. Those without OSA were older (68.5 vs 65.6 years old, p<0.001), female (50.5% vs 33.5%, p<0.001), and non-caucasian (29.7% vs 23.7%, p<0.001). The OSA group had significantly higher rates of obesity (41.4% vs 10.5%, p<0.001), atrial fibrillation (47.1% vs 42.2%, p=0.001), hypertension (87.4% vs 78.5%, p<0.001), and diabetes mellitus (41.2% vs 26.9%, p<0.001). OSA patients treated with MT demonstrated lower rates of intracranial hemorrhage (19.1% vs 21.8%, p=0.017), treatment of hydrocephalus (0.3% vs 1.1%, p=0.009), and in-hospital mortality (9.7% vs 13.5%, p<0.001). OSA was independently associated with lower rate of in-hospital mortality (aOR 0.76, 95% CI 0.69 to 0.83; p<0.001), intracranial hemorrhage (aOR 0.88, 95% CI 0.83 to 0.95; p<0.001), and hydrocephalus (aOR 0.51, 95% CI 0.37 to 0.71; p<0.001). Results were confirmed by PA. Conclusions Our findings suggest that MT is a viable and safe treatment option for AIS patients with OSA. [ABSTRACT FROM AUTHOR]

Published
2022
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32. Neurocritical care management of poor-grade subarachnoid hemorrhage: Unjustified nihilism to reasonable optimism

Author

Al-Mufti, Fawaz, primary, Mayer, Stephan A, additional, Kaur, Gurmeen, additional, Bassily, Daniel, additional, Li, Boyi, additional, Holstein, Matthew L, additional, Ani, Jood, additional, Matluck, Nicole E, additional, Kamal, Haris, additional, Nuoman, Rolla, additional, Bowers, Christian A, additional, S Ali, Faizan, additional, Al-Shammari, Hussein, additional, El-Ghanem, Mohammad, additional, Gandhi, Chirag, additional, and Amuluru, Krishna, additional

Published
2021
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33. Acute Cerebrovascular Disorders and Vasculopathies Associated with Significant Mortality in SARS-CoV-2 Patients Admitted to The Intensive Care Unit in The New York Epicenter

Author

Al-Mufti, Fawaz, primary, Becker, Christian, additional, Kamal, Haris, additional, Alshammari, Hussein, additional, Dodson, Vincent, additional, Nuoman, Rolla, additional, Dakay, Katarina, additional, Cooper, Jared, additional, Gulko, Edwin, additional, Kaur, Gurmeen, additional, Sahni, Ramandeep, additional, Scurlock, Corey, additional, Mayer, Stephan A., additional, and Gandhi, Chirag D., additional

Published
2021
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34. Fatal Cerebral Edema in a Child With COVID-19

Author

Kim, Michael G., primary, Stein, Alan A., additional, Overby, Philip, additional, Kleinman, George, additional, Nuoman, Rolla, additional, Gulko, Edwin, additional, Al-Mufti, Fawaz, additional, Pisapia, Jared M., additional, and Muh, Carrie R., additional

Published
2021
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35. Cerebral Venous Sinus Thrombosis in COVID-19 Infection: A Case Series and Review of The Literature

Author

Dakay, Katarina, primary, Cooper, Jared, additional, Bloomfield, Jessica, additional, Overby, Philip, additional, Mayer, Stephan A., additional, Nuoman, Rolla, additional, Sahni, Ramandeep, additional, Gulko, Edwin, additional, Kaur, Gurmeen, additional, Santarelli, Justin, additional, Gandhi, Chirag D., additional, and Al-Mufti, Fawaz, additional

Published
2021
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36. Management of Small Unruptured Intracranial Aneurysms

Author

Elkun, Yuval, primary, Cooper, Jared, additional, Kamal, Haris, additional, Dakay, Katarina, additional, Nuoaman, Halla, additional, Adnan, Yasir Ammar, additional, Dodson, Vincent, additional, Nuoman, Rolla, additional, Kaur, Kavneet, additional, Kurian, Christeena, additional, Sahni, Ramandeep, additional, Gandhi, Chirag, additional, and Al-Mufti, Fawaz, additional

Published
2020
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40. Bihemispheric ischemic strokes in patients with COVID-19.

Author

Kurian, Christeena, Mayer, Stephan, Kaur, Gurmeen, Sahni, Ramandeep, Feldstein, Eric, Samaan, Mena, Viswanathan, Divya, Sami, Tamarah, Ali, Syed Faizan, Al-Shammari, Hussein, Bloomfield, Jessica, Bravo, Michelle, Nuoman, Rolla, Gulko, Edwin, Gandhi, Chirag D., and Al-Mufti, Fawaz

Subjects
CORONAVIRUS diseases, STROKE, EMBOLISMS, THROMBOSIS
Abstract

BACKGROUND: There is emerging evidence that COVID-19 can trigger thrombosis because of a hypercoagulable state, including large-vessel occlusion ischemic strokes. Bihemispheric ischemic stroke is uncommon and is thought to indicate an embolic source. Here, we examine the findings and outcomes of patients with bihemispheric stroke in the setting of COVID-19. METHODS: We performed a retrospective cohort study at a quaternary academic medical center between March 1, 2020, and April 30, 2020. We identified all patients with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection who presented with simultaneous bihemispheric ischemic strokes. RESULTS: Of 637 COVID-19 admissions during the 2-month period, 13 had a diagnosis of acute ischemic stroke, including 5 who developed bihemispheric cerebral infarction. Three of those 5 (60%) were female, median age was 54 (range 41-67), and all five were being managed for severe COVID-19-related pneumonia complicated by acute kidney injury and liver failure before the diagnosis of cerebral infarction was established. Five presented with elevated ferritin, lactate dehydrogenase, and interleukin-6 (IL-6) levels, and four had lymphopenia and elevated D-dimer levels. All patients underwent neuroimaging with computed tomography for persistent depressed mentation, with or without a focal neurologic deficit, demonstrating multifocal ischemic strokes with bihemispheric involvement. Outcome was poor in all patients: two were discharged to a rehabilitation facility with moderate-to-severe disability and three (60%) patients died. CONCLUSIONS: Stroke is implicated in SARS-CoV-2 infection. Although causality cannot be established, we present the imaging and clinical findings of patients with COVID-19 and simultaneous bihemispheric ischemic strokes. Multifocal ischemic strokes with bihemispheric involvement should be considered in COVID-19 patients with severe infection and poor neurologic status and may be associated with poor outcomes. [ABSTRACT FROM AUTHOR]

Published
2022
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41. In Reply: Rescue Therapy for Procedural Complications Associated With Deployment of Flow-Diverting Devices in Cerebral Aneurysms

Author

Al-Mufti, Fawaz, primary, Amuluru, Krishna, additional, Cohen, Eric, additional, Patel, Vikas, additional, El-Ghanem, Mohammad, additional, Wajswol, Ethan, additional, Dodson, Vincent, additional, Al-Marsoummi, Sarmad, additional, Majmundar, Neil, additional, Dangayach, Neha, additional, Nuoman, Rolla, additional, and Gandhi, Chirag, additional

Published
2019
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45. Management Strategies for Intracranial Pressure Crises in Subarachnoid Hemorrhage.

Author

Ravishankar, Nidhi, Nuoman, Rolla, Amuluru, Krishna, El-Ghanem, Mohammad, Thulasi, Venkatraman, Dangayach, Neha S., Lee, Kiwon, and Al-Mufti, Fawaz

Subjects
*ABDOMINAL surgery, *BARBITURATES, *HYPERVENTILATION, *INDUCED hypothermia, *INDOMETHACIN, *INTRACRANIAL hypertension, *INTRACRANIAL pressure, *MEDLINE, *ONLINE information services, *RESPIRATORY therapy, *SODIUM bicarbonate, *SUBARACHNOID hemorrhage, *DISEASE management, *TREATMENT effectiveness, *MANNITOL, *EARLY diagnosis, *TROMETHAMINE, *DECOMPRESSIVE craniectomy, *HYPERTONIC saline solutions, *DISEASE complications, *DISEASE risk factors
Abstract

Objectives : Standard management strategies for lowering intracranial pressure (ICP) in traumatic brain injury has been well-studied, but the use of lesser known interventions for ICP in subarachnoid hemorrhage (SAH) remains elusive. Searches were performed in PubMed and EBSCO Host to identify best available evidence for evaluation and management of medically refractory ICP in SAH. The role of standard management strategies such as head elevation, hyperventilation, mannitol and hypertonic saline as well as lesser known management such as sodium bicarbonate, indomethacin, tromethamine, decompressive craniectomy, decompressive laparotomy, hypothermia, and barbiturate coma are reviewed. We also included dose concentrations, dose frequency, infusion volume, and infusion rate for these lesser known strategies. Nonetheless, there is still a gap in the evidence to recommend optimal dosing, timing and its role in the improvement of outcomes but early diagnosis and appropriate management reduce adverse outcomes. [ABSTRACT FROM AUTHOR]

Published
2020
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46. Mandatory Neuroendovascular Evolution: Meeting the New Demands

Author

El-Ghanem, Mohammad, primary, Gomez, Francisco E., additional, Koul, Prateeka, additional, Nuoman, Rolla, additional, Santarelli, Justin G., additional, Amuluru, Krishna, additional, Gandhi, Chirag D., additional, Cohen, Eric R., additional, Meyers, Philip, additional, and Al-Mufti, Fawaz, additional

Published
2018
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