Introduction Stroke is the fifth leading cause of death in the United States, resulting in greater than 125,000 deaths annually . Large brain infarctions are associated with edema and, in severe cases, shift of intracranial contents and elevation of intracranial…
Introduction Hypertensive encephalopathy is an acute syndrome characterized by acute hypertension (HTN) associated with various neurological symptoms and characteristic neuroimaging findings. The common clinical signs and symptoms of the condition include encephalopathy, seizures, headache, visual disturbances, and focal neurological deficits…
Physiological monitoring is the cornerstone of critical care; it allows for identifying hemodynamic instability and assessing response to therapy. Utility of most hemodynamic monitoring remains unproven and rather serves as a trigger for detection of cardiorespiratory instability. Some have argued…
Introduction Meticulous critical care is key to achieve the best possible outcome after stroke. There has been considerable evolution in our approach to critically ill patients over the recent years, including the establishment of standardized protocols that cover both general…
In 1996, the FDA approved the use of intravenous alteplase for the treatment of acute ischemic stroke after publication of the National Institute of Neurological Disorders and Stroke (NINDS) trial. There were five randomized controlled trials that laid the groundwork…
Introduction The presence of protruding or ulcerated atheromas in the proximal segment of the aorta is associated with an increased frequency of peripheral or cerebral embolic events . The association, initially recognized in pathology studies , was confirmed in vivo with…
Introduction Cerebral angiography was introduced and expanded by the Portuguese neurologist Egas Moniz close to a century ago . Significant morbidity and mortality in the first procedures lead to a transition to iodinated solution as contrast media, leading to satisfactory…
Introduction Transcranial Doppler ultrasound (TCD), or transcranial color-coded sonography (TCCS) and duplex ultrasound of extracranial brain supplying vessels are noninvasive methods that can be used at bedside for neurovascular examination ( Fig. 133.1 ). Ultrasound is the safest vessel imaging…
Introduction We image patients with stroke syndromes to establish a diagnosis and to guide patient management, especially when there is a reasonable likelihood of intervention improving outcomes. Computed tomography (CT)- and magnetic resonance imaging (MRI)-based imaging, often in combination, are…
Introduction A stroke is a sudden loss of neurological function due to brain parenchyma damage caused by a cerebrovascular disorder. It can be caused either by the sudden loss or significant decrease of blood flow to a specific brain region…