Textbook of Neurointensive Care - Volume 1 - Neuroanatomy, Diagnostic Assessment, Disease Management, 3e (Nov 22, 2024)_(3031622197)_(Springer).pdf

Foreword
Preface
Contents
Part I: Neuroanatomy, Physiology and Neurological Examination
	1: The Functional Organization of the Nervous System
		Introduction
		Neurological Examination
			Mental Status
			The Pupil
			The Cranial Nerves (Fig. 1.2)
				The Olfactory Nerve
				The Optic Nerve
				The Oculomotor Nerve
				The Trochlear Nerve
				The Trigeminal Nerve
				The Abducens Nerve
				The Facial Nerve
				The Vestibulocochlear Nerve
				The Glossopharyngeal Nerve
				The Vagus Nerve
				The Spinal Accessory Nerve
				The Hypoglossal Nerve
			The Motor Function
			Reflexes
			Sensation
			Special Senses
				Vision
				Hearing
				Taste and Smell
			Herniation Syndromes
		Clinical Anatomical Correlation in Neurological Disease
			The Cerebral Cortex
				The Dominant Hemisphere
				The Nondominant Hemisphere
				The Frontal Lobes
				The Temporal Lobes
				The Parietal Lobes
				The Occipital Lobes
			The Brain Stem
			The Spinal Cord
			The Peripheral Nerves
			The Neuromuscular Junction
			The Muscle
		Conclusions
		References
	2: A Multidisciplinary Approach to Neurocritical Care
		History and Evolution of Intensive Care Medicine
		Need for Specialized Units
		Neurocritical Care as a Subspecialty
		Intensive Care Unit Organization
		ICU Staffing
			Physicians
			Nurses
			Advance Practice Providers
			Pharmacists
			Additional Disciplines
		Workflow in an ICU
		Quality Metrics in an ICU
		Teleneurointensive Care Unit (Teleneuro-ICU)
		Impact of COVID-19 on Healthcare
		Conclusions
		References
	3: Fundamentals of Neuroradiological Imaging
		Introduction
		Plain Radiographs
			Basic Concepts
			Strengths and Weaknesses
			Clinical Applications
			Rational Use
		Computed Tomography
			Basic Concepts
			Strengths and Weaknesses
			Clinical Applications
			Rational Use
		Conventional Computed Tomography
		Computed Tomography Angiography
		Computed Tomography Perfusion (CTP)
		Dual-Energy Computed Tomography (DECT) and Spectral Computed Tomography
		Portable Computed Tomography (PCT)
		Photon-Counting Computed Tomography
		Magnetic Resonance Imaging
			Basic Concepts
			Strengths and Weaknesses
			Clinical Applications [11]
			Rational Use
		Nuclear Medicine
			Basic Concepts
			Strengths and Weaknesses
			Clinical Applications
			Rational Use
		Ultrasound
			Basic Concepts
			Strengths and Weaknesses
			Clinical Applications
			Rational Use
		Digital Subtraction Angiography (DSA)
			Basic Concepts
			Strengths and Weaknesses
			Clinical Indications
			Rational Use
		Conclusions
		References
	4: Clinical Neuroimaging in the Intensive Care Unit
		Introduction
		Neurovascular Diseases
			Acute Ischemic Stroke
				Noncontrast CT Head
				CT Angiogram
				CT Perfusion
				MRI
			Intracerebral Hemorrhage
				Noncontrast CTH
				CT Angiogram
				MRI
			Subarachnoid Hemorrhage
		Aneurysmal Subarachnoid Hemorrhage
			Noncontrast CTH
			MRI
			CT Angiogram
		Delayed Cerebral Ischemia
		Nonaneurysmal SAH
			Reversible Cerebral Vasoconstrictive Syndrome (RCVS)
				Noncontrast CTH
				MRI Brain
				CT Angiogram, MR Angiogram
			Cerebral Venous Sinus Thromboses (CVST)
				Noncontrast CTH
				MRI
				CT and MR Venography
			Posterior Reversible Encephalopathy Syndrome (PRES)
				Noncontrast CTH
				MRI
			Spinal Cord Infarction
				MRI
		Non-Neurovascular Diseases
			Brain Tumors
			Noncontrast CT Head
			MRI Brain
		Positron Emission Tomography (PET) Scan
			CNS Infection
				Noncontrast CT Head
				MRI
			CSF Shunt or Device Infection
			Ventriculitis
			Traumatic Brain Injury
				Noncontrast CT Head
				MRI
			Hypoxic Ischemic Encephalopathy
				Noncontrast CT Head
				MRI Brain
				MR Spectroscopy
			Spinal Cord Compression
				CT Spine
				MRI Spine
				CT Myelography
		Conclusion
		References
Part II: Signs, Symptoms and Management
	5: Diagnosis and Treatment of Altered Mental Status
		Introduction
		Presentations and Descriptions of Acute Alterations in Consciousness
		Neurocircuitry Underpinning the Level of Arousal
		Physical Examination and Evaluation in the ICU Setting
			General
			Cardiac and Carotid Examination
			Pulmonary Examination and Respiratory Patterns
			Abdominal Examination
			Skin/Nail Examination
			Neurological Examination
				Glasgow Coma Scale (GCS)
				Full Outline of Unresponsiveness (FOUR) Score
				Higher Cortical Function
				Cranial Nerves
					Pupillary Reflex
					Corneal Reflex
					Vestibulo-Ocular Reflex and Cold Caloric Testing
					Cough and Gag Reflex
				Funduscopic Examination
				Motor Examination
				Basal Ganglia Examination
				Deep Tendon Reflex Examination
				Cerebellar Examination
				Sensory Examination
		Laboratory Workup
			Complete Blood Count (CBC)
			Chemistries
		Neuroimaging
			CT
			MRI
		Neuro-diagnostics
			Lumbar Puncture
			EEG
		Diseases and Disease-Specific Treatments
			Delirium
			Intoxications
				Sedatives
				Cocaine and Other Sympathomimetics
				LSD
				GHB
				Narcotics
			Ischemic Disease
				Stroke
			Hemorrhagic Disease
				Intraparenchymal Hemorrhage
				Subarachnoid Hemorrhage
			Neoplasm
			Posterior Reversible Encephalopathy Syndrome (PRES)
			Demyelinating Disease
			Infections
				Meningitis
				Encephalitis
				Cerebral Abscess
			Intracranial Hypotension
			Epileptiform Activity
				Convulsive Status Epilepticus
				Nonconvulsive Status Epilepticus (NCSE)
			Immune-Mediated Encephalopathies
		References
	6: Seizures in the Intensive Care Unit
		Introduction
		The Pathophysiology of Status Epilepticus
		Definition and Classification of Seizures and Status Epilepticus
		When to Suspect Seizures
		Interictal and Ictal EEG Patterns
		Challenging EEG Patterns
		Seizure Etiology
			Subarachnoid Hemorrhage (SAH)
			Stroke
			Traumatic Brain Injury
			Intracranial Tumors
			Metabolic Disorders
				Sodium Abnormalities
				Glucose Abnormalities
				Calcium Abnormalities
				Magnesium Abnormalities
			Renal Failure
			Hepatic Failure
			Alcohol and Other Drug-Induced Seizures
			Central Nervous System Infections and Sepsis
			Unknown Etiology of Seizures
			Seizures and Organ Transplantation
			Status Epilepticus, Refractory, and Super-Refractory Status Epilepticus
			Status Epilepticus Outcome and Prognosis
			Pharmacological Treatment
			Emergent Initial Therapy
			Urgent Control Therapy
			Levetiracetam
			Fosphenytoin/Phenytoin
			Valproic Acid
			Phenobarbital
			Adjunctive ASMs
			Anesthetic Therapy for RSE and SRSE
			Midazolam
			Propofol
			Ketamine
			Pentobarbital
		Non-pharmacological Treatment of Seizures
		Conclusions
		References
	7: Intracranial Hypertension: Signs, Symptoms, and Management
		Introduction
		Discussion of Concepts
			Intracranial Pressure, Intracranial Volume, and Compliance
			Cerebral Blood Flow and Cerebral Autoregulation
			Cerebral Perfusion Pressure
			Clinical Significance of ICP, CPP, and CBF
		Conditions that Cause Intracranial Hypertension
			Disorders of the Arterial and Venous Structures
			Disorders of CSF Production and Absorption
			Intra-Axial and Extra-Axial Space-Occupying Lesions
				Vasogenic Edema
				Cytotoxic Edema
				Osmotic Edema
				Hydrostatic Edema
		Signs and Symptoms of Intracranial Hypertension
		Herniation Syndromes
			Subfalcine Herniation
			Uncal Herniation
			Central Herniation
			Tonsillar Herniation
			Upward Herniation
		ICP Monitoring
			Indications for Monitoring Intracranial Pressure
			Traumatic Brain Injury
				Subarachnoid Hemorrhage and Intraparenchymal Hemorrhage
				Cerebral Edema from Acute Liver Failure (ALF)
				Other Conditions Causing Elevated ICP
			Modes of Monitoring
		Interpreting the ICP Waveform
			Components of the ICP Waveform
			Time-Dependent Fluctuations in ICP
		Management of Intracranial Hypertension
			Diagnosing Intracranial Hypertension
			Thresholds for ICP-Lowering Treatment
			Strategies for ICP Management
			Techniques for Reducing ICP
				Treatments to Reduce Arterial and Venous Blood Volume
				Treatments to Reduce CSF Volume
				Treatments for Brain Edema
				Initial Management to Reduce Cerebral Metabolic Demand
				Advanced Treatments to Reduce Cerebral Metabolism
				Surgical Decompression for Focal Mass Lesions and Intracranial Hemorrhage
		Conclusions
		References
	8: Acute Focal Deficit
		Introduction
		Essential Management Priorities
			Early: Immediate and First 24 h
				Examination and Localization
				Airway, Breathing, Circulation (ABCs)
				Herniation Syndromes
			Next Steps
				Imaging
				Electroencephalogram (EEG)
				Electrolyte Disturbances
				Multimodality Monitoring
				Metabolic Disturbances
		Classic Near Misses
			Diagnostic Algorithm
			Take Home Message
			Diagnostic Flow Diagram
			Treatment Flow Diagram
		References
			Further Reading
	9: Dyspnea and Respiratory Distress in the Neuro ICU
		Introduction
		The Respiratory System
		Respiratory Mechanics
		Pulmonary Perfusion
		Hypoxemia
		Hypercapnia
		Neurologic Control of Respiration
		Dyspnea
		Respiratory Failure
		Essential Management Priorities
			General Work Up of Dyspnea
			Prevention of Dyspnea and Respiratory Failure
			Acute Management of Respiratory Failure
			Noninvasive Respiratory Support
			Invasive Mechanical Ventilation
			Acute Respiratory Distress Syndrome (ARDS)
			Extracorporeal Membrane Oxygenation (ECMO)
		Specific Concerns in the Neurological ICU
			Implications of Comorbid Conditions
			Optimizing Ventilation in Acute Brain Injury
			Acute and Chronic Respiratory Failure in Neuromuscular Diseases
			GBS
			Myasthenia Gravis
			Parkinson’s Disease
			Central Nervous System Pathology
			SCI
			Long-Term Ventilator Management
				Ventilator Weaning
		Conclusions
		References
	10: Hypotension and Shock
		Introduction
		Epidemiology
		Shock Definition
		Pathophysiology
		Shock States
		Neural Mechanisms of Blood Pressure Control
		Cerebral Autoregulation
		Cerebral Perfusion Pressure and Intracranial Pressure
		Monitoring Techniques
		Arterial Line
		Central Venous Pressure
		Cardiac Output
		Etiologies and Management of Shock States
			Immediate Management and Diagnostic Strategies
		Hypovolemic Shock
			Non-hemorrhagic Hypovolemic Shock
			Hemorrhagic Shock
			Burn Shock
		Distributive Shock
			Septic Shock
			Anaphylactic Shock
			Neurogenic Shock
			Shock Due to Endocrinopathies
		Cardiogenic Shock
		Obstructive Shock
		Near Misses
		Conclusion
		References
	11: Uncontrolled Hypertension
		Introduction
		Epidemiology
		Hypertensive Emergency Versus Urgency
		Physiology of Blood Pressure Homeostasis
			Autonomic Feedback
			Intravascular Volume Regulation
		Physiology of Hypertension
			Sympathetic Dysregulation
			Vascular and Endothelial Dysfunction
			Sodium Chloride Imbalance
		Uncontrolled Hypertension and Cerebral Autoregulation
		Autonomic Receptors
			Alpha-1 Receptors
			Alpha-2 Receptors
			Beta Receptors
		Pharmacological Management of Uncontrolled Hypertension
		Organ-Specific Hypertensive Emergencies
			Neurologic Emergencies
				Ischemic Stroke
				Spontaneous Intracerebral Hemorrhage
				Hypertensive Encephalopathy
				Hypertensive Retinopathy
			Cardiac Emergencies
				Acute Heart Failure
				Acute Coronary Syndrome
			Vascular Emergencies
				Acute Aortic Dissection
			Renal Emergencies
				Acute Hypertensive Nephrosclerosis
			Obstetric Emergencies
				Pregnancy, Pre-eclampsia & Eclampsia
		Sympathetic Dysregulation
			Sympathomimetic Agents
		Dysautonomia
			Neurogenic Essential Hypertension
			Withdrawal of Anti-Hypertensive Agents
			Autonomic Dysreflexia Following Spinal Cord Injury
			Guillain Barre Syndrome
			Neurodegenerative Disorders
			Catecholamine-Secreting Neoplasms
		Conclusion
		References
	12: Chest Pain and Arrhythmias in the Neurointensive Care Unit
		Introduction
		Cardiac Causes of Chest Pain
		Myocardial Infarction in Neurologic Patients
		Hypertensive Emergencies in the Neurological Patient
		Aortic Dissection
		Cardiac Chest Pain as a Result of Neurologic Injury: The Brain–Heart Interaction
		Acute Noncardiac Neurologic Chest Pain
		Arrhythmias in the Neurointensive Care Unit
			Abnormal ECGs Associated with Neurologic Emergencies
			Bradyarrhythmias in the Neuro ICU
			Tachyarrhythmias in the Neuro ICU
			Sinus Tachycardia
			Supraventricular Tachycardia
			Wide Complex Tachycardia
		Near Misses in Patients with Chest Pain or Arrhythmia
		Conclusion
		References
	13: Bodily Water and Electrolyte Abnormalities in Neurological Disease
		Introduction
		Pathophysiology of Bodily Water and Sodium Balance
		Regulation of Sodium and Effective Plasma Volume
		Hyponatremia
		Evaluation/Diagnostic Workup of Hyponatremia
		Treatment of Hyponatremia (Figs. 13.4 and 13.5)
		Hypernatremia
		Clinical Manifestation of Hypernatremia
		Common Causes of Hypernatremia in the Neurointensive Care Unit
		Diabetes Insipidus
		The Approach to the Hypernatremic Patient
		Potassium Disturbances
		Hyperkalemia
		Clinical Manifestations of Hyperkalemia
		Management of Hyperkalemia
		Hypokalemia
		Clinical Manifestations of Hypokalemia
		Management of Hypokalemia
		Disorders of Calcium, Phosphorus, and Magnesium Homeostasis
			Calcium Disorders
				Hypercalcemia
				Management of Hypercalcemia
				Hypocalcemia
			Phosphorus Disorders
				Hyperphosphatemia
				Hypophosphatemia
			Magnesium Disorders
				Hypermagnesemia
				Hypomagnesemia
		References
	14: Oliguria, Acute Kidney Injury, and Principles of Blood Purification
		Introduction
		Consensus Definitions and Oliguria
		Epidemiology and Outcomes of AKI in Neurocritical Pathologies
		Risk Factors of AKI in Neurocritical Care Unit Patients
		Physiopathology of AKI in Nerocritical Care Unit Patients
			The Brain–Kidney Connection
			Inflammation
			Blood Flow Dysregulation
			Neurotransmitter Alteration
		Cause of AKI in Neurocritical Care Unit Patients
			Traumatic Brain Injury-Induced Acute Kidney Injury (TBI-iAKI)
			Acute Kidney Injury in Subarachnoid Hemorrhage
			Acute Kidney Injury in Acute Ischemic Stroke and Intracerebral Hemorrhage
		Principles of Blood Purification in the Neurocritical Care Unit
			Mechanisms of Solute and Fluid Transport
			Ultrafiltration and Convection
			Diffusion
			Adsorption
		Renal Replacement Therapy in Neurocritical Care
		Conclusions
		References
	15: Acid and Base Abnormalities
		Introduction
		Essential Management Priorities
			Early: Immediate and First 24 h
			Intermediate Term
			Classic Near Misses
		Diagnostic Algorithm
			Respiratory Alkalosis and Acidosis
			Metabolic Alkalosis and Acidosis
			Acid–Base Balance and Cerebral Blood Flow
		References
	16: Dysfunctional Hemostasis
		Normal Hemostasis
			Primary Hemostasis
			Secondary Hemostasis
			Evaluation of Hemostasis
		Disorders of Hemostasis—Intrinsic Mechanisms
			Disorders of Primary Hemostasis
			Quantitative Platelet Disorders
				Thrombocytopenia
				Thrombocytosis
			Essential Thrombocytosis
				Qualitative Platelet Disorders
			Disorders of Secondary Hemostasis
			Disorders of Fibrinolysis
				Disorders of Hemostasis—Extrinsic Mechanisms and Antithrombotic Agents
					Risk of Intracranial Hemorrhage in Patients on Antithrombotic Agents
			Management of Coagulopathy Associated with Liver Failure, Uremia, and Ethanol Use
				Liver Failure
				Uremia
				Alcohol Use
			Resumption of Antithrombotic
			Alternatives to Resumption of Anticoagulants
				Antiplatelets
				Left Atrial Appendage Closure
		References
	17: Jaundice and Abnormal Liver Function Tests
		Introduction
		Common Liver Biochemical and Function Tests
		Patterns of Liver Chemistry Test Elevations
		Hepatocellular Injury
		Cholestatic Injury
		Synthetic Function
		Bilirubin and Jaundice
		Common Etiologies and Management of Liver Injury in Critically Ill Patients
			Ischemic Hepatitis
			Acute Liver Failure
			Acute-on-Chronic Liver Failure
			Decompensated Cirrhosis
			Drug-Induced Liver Injury
		Secondary Sclerosing Cholangitis in Critically Ill Patients
			Acute Acalculous Cholecystitis
			COVID-19 Infection
		Conclusion
		References
	18: Gastrointestinal Emergencies
		Introduction
		Gastrointestinal Hemorrhage
		Presentation
		Upper GI Bleeding
		Lower GI Bleeding
		Intestinal Ischemia
		Acute Mesenteric Ischemia
		Acute Colonic Ischemia
		Diagnosis and Management of Cholangitis for Intensive Care Unit Patients
			Introduction to Cholangitis
			Etiology
			Diagnosis
			Non-invasive Imaging Modalities
			Treatment
			Conclusion
		Acute Liver Failure
		Causes/Evaluation
		Management
		Conclusions
		References
	19: Fever and Therapeutic Hypothermia
		Introduction
			Fever
			Therapeutic Hypothermia and Targeted Temperature Management
		Disease States (See Table 19.2)
			Acute Ischemic Stroke
			Intracerebral Hemorrhage
			Subarachnoid Hemorrhage
			Traumatic Brain Injury
			Status Epilepticus
			Spinal Cord Injury
		Management
			Shivering
			Other Management Considerations
		Conclusions
		References
Part III: Specific Diagnosis, Diseases and Management
	20: Subarachnoid Hemorrhage: Overview of Management
		Background
		Epidemiology
		Standard Case Presentation
		Imaging Diagnostics
		Data Supported Guidelines
			Recommendations for Diagnosis
			Stabilization and Preventing Rebleed
			Antifibrinolytic Therapy
			Seizures
			Hydrocephalus
			Medical Complications
			Systems of Care
		Treatment
			Clipping
			Coiling
			Alternatives
		Cerebral Vasospasm
			Diagnosis
			Treatment
		Conclusion
		References
	21: Intracerebral Hemorrhage
		Introduction
		Epidemiology
		Risk Factors
		Clinical Presentation
		Essential Management Priorities
			Early: Immediate/First 24 h
				Airway
				Blood Pressure
				Intracranial Pressure
				Coagulopathy Reversal
				Seizure Management
		Neuroimaging
		Medical Management After Stabilization
			Hematoma Expansion
			Cerebral Edema
			Intracranial Pressure Monitoring
		Surgical Management
			Open Surgery
			Minimally Invasive Surgical Evacuation
			Cerebellar Hemorrhage
			ICH with IVH
		Conclusion
		References
	22: Arteriovenous Malformations: Evidence-Based Medicine, Diagnosis, Treatment, and Complications
		Definition
		Epidemiology and Natural History
		Critical Care Management
			Acute Evaluation
			Radiographic Assessment
			Anesthetic Considerations
		Grading and Surgical Management
			AVM Grading
			Treatment Modalities for AVM Management
				Endovascular Embolization
				Stereotactic Radiosurgery
				Microsurgical Resection
			AVMs and Pregnancy
		Intraoperative and Postoperative Care
		Conclusions
		References
	23: Central Nervous System Vasculitis
		Introduction
		Secondary CNS Vasculitides
			Large-Vessel Vasculitides
				Giant Cell Arteritis
				Takayasu Arteritis
			Medium-to-Small Vessel Vasculitides
				Polyarteritis Nodosa
				ANCA-Associated Vasculitis
				Cryoglobulinemia
				Behcet’s Disease
			CNS Vasculitides Associated with Systemic Diseases
				Systemic Lupus Erythematosus
				Rheumatoid Arthritis
		Infectious CNS Vasculitides
			Viral
				Human Immunodeficiency Virus
				Varicella Zoster Virus
			Bacterial
				Pyogenic Bacterial Meningitis
				Mycobacteria
				Spirochetes
			Fungal
			Parasites
		Other Specific Causes of CNS Vasculitis
		Primary Angiitis of the Central Nervous System
		References
	24: Acute Ischemic Stroke1
		Introduction
		Hyperacute Management of Ischemic Stroke
			Hemodynamic Goals
		Complications of Acute Ischemic Stroke
			Cerebral Edema
				Malignant MCA Stroke
				Pathophysiology
				Management
				Malignant Cerebellar Infarction
			Hemorrhagic Transformation
			Angioedema
		Secondary Stroke Prevention
		Post-ICU Care
		References
	25: Cerebral Venous Sinus Thrombosis
		Introduction
		Clinical Presentation
		Risk Factors/Causes
			Inherited Thrombophilias
			Acquired Pro-Thrombotic Conditions
				Antiphospholipid Antibody Syndrome (APLS)
				Cancer
				Pregnancy and Puerperium
				Oral Contraceptives
				Heparin-Induced Thrombocytopenia/ Vaccine-Induced Thrombotic Thrombocytopenia
				Other Pro-Thrombotic Conditions
			Infections
			Mechanical and Procedural Factors
		Essential Management Priorities
			Early: Immediate/First 24 h
			Subsequent Inpatient Management
			Long-Term Clinical Course
		Near Misses
			Failure to identify ICH as due to CVST
			Deep CVST and Coma
			CVST Mimicking Idiopathic Intracranial Hypertension (IIH)
			CVST from Underlying Infection
			Adenoviral-Vector COVID-19 Vaccination and CVST
		Key Radiographic Findings
			Imaging Modalities
		Key Monitoring
			Intracranial Hypertension
			Papilledema
			Seizures
			Therapeutic Anticoagulation
			Herniation
		Further Reading
			Key/Landmark References
	26: Traumatic Brain Injury: Evidence-Based Medicine, Diagnosis, and Treatment
		Epidemiology
		Pathophysiology
		Diagnosis
		Treatment of Severe TBI
		Blood Pressure
		Systemic Oxygenation
		Intracranial Pressure (Table 26.3)
			Monitoring
			ICP Treatment
			Osmotherapy
			Hyperventilation
			Paralysis
			Hypothermia
			Surgical Decompression
			Steroids
			Sedation
		CPP/Autoregulation
		Brain Tissue Oxygen Tension (PbtO2)
		Brain Chemistry (Microdialysis)
		Seizure Prophylaxis
			Nutrition
		Conclusion
		References
	27: Traumatic Neurovascular Injury
		Introduction
		Epidemiology
		Pathophysiology
		Disease Subtypes
		Essential Management Priorities
			Early: Immediate/ First 24 h (Table 27.3)
				Making the Diagnosis (Fig. 27.1)
					Screening
					Who to Screen
					How to Screen
						Digital Subtraction Arteriography (DSA)
						Duplex Ultrasonography
						Magnetic Resonance Angiography (MRA)
						Computed Tomographic Angiography (CTA)
				Treatment (Fig. 27.2)
					Antithrombotic Therapy
					Surgical Repair
					Endovascular Treatment
			Long-Term Clinical Course
		Key Monitoring
		References
			Key/Landmark References
	28: Acute Traumatic Spinal Cord Injury
		Epidemiology
		Pathophysiology
		Initial Evaluation and Resuscitation
		Imaging Assessment
		Surgical Management of SCI
		Acute Medical Management of SCI
			Respiratory Management
				Intubation and Mechanical Ventilation
				Pneumonia
				Tracheostomy
			Hemodynamic Management
				Neurogenic Shock
				MAP Augmentation and Spinal Cord Perfusion
				Autonomic Dysreflexia
				Venous Thromboembolism
			Other Acute Care Considerations
				Gastrointestinal
				Genitourinary
				Pressure Ulcers
				Pain
				Psychosocial
		Neuroprotection and Neuroregeneration
			Neuroprotective Drugs
				Methylprednisolone Sodium Succinate (MPSS)
				Minocycline
				Riluzole
				Acidic Fibroblast Growth Factor
				Granulocyte Colony-Stimulating Factor
			Non-Pharmacological Neuroprotective Strategies
				Therapeutic Hypothermia
			Neuroregenerative Therapies
				Rho-ROCK Inhibition
				Anti-Nogo-A Antibody
				Anti-RGMa-Antibody
				Cell-Based Therapies
				Biomaterial Scaffolds
			Neuromodulation
		Conclusion
		References
	29: The Management of Brain Tumor Patients in the Neurointensive Care Unit
		Introduction
			Epidemiology
			Characterization
				Primary Versus Metastatic Tumors
				Intra-Axial Versus Extra-Axial Tumors
				Ventricular Tumors
			Approaches to Treatment
				Open Surgery
				Minimally Invasive Techniques
				Laser Interstitial Thermal Therapy (LITT)
				Non-Surgical Approaches
					The Patient with a Brain Tumor in the Neuro ICU
			Pre-Operative Phase of Care
				Admission for Preoperative Monitoring or Optimization
			Post-Operative Phase of Care
		Conclusion
		References
	30: Autoimmune Encephalopathies Presenting in the ICU
		Introduction
		Epidemiology
		Pathophysiology
		Disease Subtypes
		Essential Management Priorities
			Early: Immediate/First 24 h
				Diagnosis
				Treatment
					Immunotherapy
					Management of Complications
			Long-Term Clinical Course
			Near Misses
				Misdiagnosis
				Insufficiently Aggressive Treatment
		Key Radiologic Findings
		Key Monitoring
		References
			Key/Landmark References
	31: Central Nervous System Infections
		Introduction
		Routes of Infection
		Acute Bacterial Meningitis
			Definition
			Epidemiology
				Streptococcus pneumoniae
				N. meningitidis
				H. influenza
				Listeria monocytogenes
				Other Microorganisms
			Pathogenesis of Meningeal Invasion
			Clinical Manifestations
			Diagnosis
			Lumbar Puncture and CSF Analysis
			Miscellaneous Testing
			Imaging Studies
			Treatment
			Complications
			Seizures
			Vaccination for Meningitis
		Viral Meningitis and Encephalitis
			Epidemiology
			Pathogenesis
			Clinical Manifestations
			Treatment
		Brain Abscess
			Pathogenesis
			Microbiology
			Clinical Manifestations
			Diagnosis
			Treatment
		Spinal Epidural Abscess
			Pathophysiology
			Risk Factors
			Microbiology of Spinal Epidural Abscess Formation
			Clinical Features and Diagnostic Considerations
			Treatment
		Vertebral Osteomyelitis
			Pathogenesis
			Microbiology of Vertebral Osteomyelitis
			Clinical Presentation and Diagnostic Considerations
			Treatment
		External Ventricular Drainage
			Infectious Considerations
		Mycobacterium Tuberculosis Infections
			Tuberculous Meningitis
				Pathogenesis
				Clinical Presentation
				Diagnosis
				Treatment
				Prognosis and Sequelae
			Tuberculoma
			Spinal Tuberculosis
		CNS Infections Caused by Rapidly Growing Mycobacteria
		Fungal CNS Infections
			Fungal Meningitis
			Cryptococcus Meningitis
			Histoplasmosis
				Treatment
			Coccidioidal Meningitis
				Pathogenesis
				Treatment
			Blastomycosis
				Pathogenesis
				Clinical Manifestations
				Diagnosis
				Treatment
			Candida CNS Infections
			Zygomycetes and Zygomycosis
			CNS Infections Caused by Aspergillus Species
		Opportunistic Infections Associated with HIV Infection
			Toxoplasma Gondii
				Clinical Manifestations
				Diagnosis
				Treatment
			Cytomegalovirus (CMV)
				Treatment
			HIV Encephalopathy and Dementia
		Parasitic Infections of the Central Nervous System
			Cerebral Malaria
				Pathogenesis
				Treatment
			Amoebic Meningoencephalitis
			Neurocysticercosis
				Treatment
			Echinococcus
			Strongyloidiasis
			Toxocariasis
		Syphilis
			Pathogenesis
			Neurosyphilis
			Serologic Testing
			Treatment
		Lyme Disease
			Pathogenesis
			Treatment
		Miscellaneous Infections with CNS Complications
			Rickettsial Disease
			Human Ehrlichiosis
			Human Bartonellosis (Cat-Scratch Disease)
			Whipple’s Disease
			Subacute Sclerosing Panencephalitis (SSPE)
			Progressive Multifocal Leukoencephalopathy
			Coronavirus Infection
		References
	32: Status Epilepticus
		Introduction
		Definitions
		Etiology
		Classification
		Pathophysiology
		Diagnosis
		Electroencephalography
		Imaging
		Treatment
			Emergent Initial Therapy
			Urgent Control Therapy
			Treatment of Refractory SE and Super-Refractory SE
			Treatment of Focal Motor and Nonconvulsive SE
		References
	Untitled
	33: Neuromuscular Disorders
		Introduction
		Myasthenia Gravis
			Immediate Management
			Long-Term Clinical Course
			Near Misses
			Key Monitoring
		Guillain-Barre Syndrome
			Clinical Presentation
				Early/Immediate Management
				Key Monitoring
			Treatment Pearls
			Therapeutic Modalities
				Long Term Clinical Course
			Near Misses
			Complications of Plasmapheresis and IVIg
				A Comment on SARS-CoV-2 and GBS
		Amyotrophic Lateral Sclerosis
			Early/Immediate Managment
			Long-Term Clinical Course
			Near Misses
			Key Radiologic Features
			Key Monitoring
		Intensive Care Unit Acquired Weakness
			Immediate/Early Managment
			Long-Term Clinical Course
			Near Misses
			Diagnostic Testing
		Lambert-Eaton Myasthenic Syndrome
			Immediate Management
			Long-Term Clinical Course
			Near Misses
			Key Monitoring
		Botulism
			Immediate Management
			Long-Term Clinical Course
			Key Monitoring
		Conclusion
		References
	34: Cardiac Implications of Neurological Disease
		Introduction
		The Brain and the Heart
		Neurological Disease and the Heart
			Subarachnoid Hemorrhage
			Ischemic Stroke
			Intracerebral Hemorrhage
			PRES and Cardiac Abnormalities
			Traumatic Brain Injury
			Spinal Cord Injury
			Guillain-Barrè Syndrome and Peripheral Neuropathies
			Myasthenia Gravis
			Dermatomyositis and Polymyositis
			Epilepsy
		Degenerative Neurological Diseases and the Heart
			Synucleinopathies
				Parkinson’s Disease (PD), Multiple-System Atrophy (MSA), and Lewy Body Dementia (LBD)
			Tauopathies
				Alzheimer Disease (AD), Progressive Supranuclear Palsy (PSP), Cortico-Basal Degeneration (CBD), and Frontotemporal Dementia (FTD)
		Muscular Dystrophies
		Miscellanea
			Patent Fossa Ovalis Associated Neurological Syndromes
		References
	35: Endocrine Issues in Neurocritical Care
		Introduction
		Anatomy and Physiology of the Hypothalamic–Pituitary Axis (HPA)
		Pathophysiology of the HPA
			Etiology
			Symptomatology and Diagnosis
			Management
		Neuroendocrine Stress Response in Critical Illness
			Dysglycemia in the Neurointensive Care Unit
			Hormonal Changes During the Acute Phase of Critical Illness
				Hormonal Changes During the Chronic Phase of Critical Illness
			Endocrine Issues in Specific Neuropathology
				Stroke
				Subarachnoid Hemorrhage
				Ischemic Stroke
				Traumatic Brain Injury and Adrenal Insufficiency
				Progressive Neurologic Disease: Guillain Barré Syndrome
				Endocrine Abnormalities and Guillain Barré Syndrome
				Endocrine Abnormalities in Meningitis/Encephalitis
			Endocrine Response in CNS and Endocrine-Secreting Tumors
				Pituitary Tumors
				Perioperative Management of Pituitary Adenomas
				Craniopharyngiomas
				Meningiomas
				Hormonal Therapy for Critical Illness
		Altered Mental Status and Endocrine Abnormalities
			Drug-Induced Endocrine Abnormalities in the NICU
				Drug-Induced Adrenal Abnormalities
				Drug-Induced Thyroid Hormone Abnormalities
				Drug-Induced Glucose Abnormalities
		The Endocrinopathy of Brain Death
		Summary
		References
	36: Cardiac Arrest and Post-Arrest Management
		Introduction
		Prehospital Care
		Essential Management Priorities
			Post-Arrest Care: Early Phase (0–6 h Post Arrest)
			Post-Arrest Care: ICU Phase—TTM
			Post-Arrest Care: ICU Phase—Cardiac Management
			Post-Arrest Care: ICU Phase—Prognostication and Neurologic Management
			Post-Arrest Care: ICU Phase—Family Management
			Post-Arrest Care: ICU Discharge and Long-Term Management
		Selected Challenges During Post-Arrest Care: Avoid These Near Misses
			Challenges During TTM Administration
			Challenges During Early Post-Arrest Care
			Challenges During Post-ICU Care
		Conclusions
		References
	37: Neurologic Prognostication in Neurocritical Care
		Clinical Significance of Neurologic Prognostication
		Self-Fulfilling Prophecy in Prognostication
		Neurologic Prognostication in Specific Disease States
		Hypoxic–Ischemic Brain Injury
			Background
			Pre-Requisites to Neurologic Prognostication in Cardiac Arrest Survivors
			Clinical Assessment
				Consciousness
				Brainstem Reflexes
				Motor Responses
			Neuroimaging Markers
			Neurophysiologic Markers
				Electroencephalogram
				Somatosensory Evoked Potentials (SSEP)
			Serological Biomarkers
			Future Directions
		Intracerebral Hemorrhage (ICH)
			Background
			Clinical Assessment
			Neuroimaging Markers
			Serologic and Neurophysiologic Biomarkers
			Future Directions
		Ischemic Stroke
			Background
			Clinical Assessment
			Serological and Neurophysiological Biomarkers
			Malignant Infarcts and Decompressive Hemicraniectomy
			Future Directions
		Traumatic Brain Injury (TBI)
			Background
			Clinical Assessment
			Neuroimaging Markers
			Serologic and Neurophysiologic Biomarkers
			Future Directions
		Aneurysmal Subarachnoid Hemorrhage (SAH)
			Background
			Clinical and Neuroimaging Assessment
			Neuroimaging Markers
			Serologic and Neurophysiologic Biomarkers
			Future Directions
		Prevailing Challenges in Neurologic Prognostication
			Clinical Course and Outcomes
			Self-Fulfilling Prophecy
			Culture and Communication
			Future Directions
		References
	38: Brain Death
		Introduction
		Prehospital
		Essential Management Priorities
			Early: Immediate/First 24 hours
			Long-Term Clinical Course
			Near Misses
		Key Radiologic Findings
		Key Monitoring
		References
			Further Reading
	39: Brain Death and Management of the Potential Organ Donor
		Introduction
		Consent
		Donation After Circulatory Determination of Death (Non-heart Beating Donors)
			Donation After Cardiac Death
		Donation After Brain Death Determination of Death (Brain Dead Heart-Beating Donors)
			Pathophysiology of Brain Death
			Specific Organ Support
				Cardiovascular and Hemodynamic Management
				Hormonal Replacement Therapy (HRT)
				Pulmonary and Respiratory Care Management
				Renal, Fluids, and Electrolyte Management
				Additional Supportive Care
		References
Index