965A.J. Layon et al. (eds.), Textbook of Neurointensive Care, DOI 10.1007/978-1-4471-5226-2, © Springer-Verlag London 2013

Index

A ACDF. See Anterior cervical discectomy and fusion (ACDF) Activities of daily living (ADLs) , 24 Acute cerebral ischemia , 831 Acute disseminated encephalomyelitis , 101 Acute hemorrhagic leukoencephalopathy , 101 Acute intermittent hemodialysis (IHD) , 386 Acute ischemic stroke (AIS) , 241, 242, 245, 247

evaluation , 696 large vessel occlusion

ACA stroke , 694 causes , 695 MCA stroke , 694 PCA stroke , 695 stroke mimics , 695

neurological complications cerebral edema and subsequent herniation , 703–704 hemorrhagic transformation , 704 seizures , 704

palliative care , 705 pathophysiology

brain stem small vessel ischemic strokes , 694 cerebral embolism , 694 classifi cation , 693, 694 large vessel ischemic stroke , 694 small vessel (lacunes) infarctions , 693–694

supportive care , 704–705 thrombolysis

blood pressure management , 700–701 intra-arterial thrombolysis , 701–702 intravenous thrombolysis , 698–700 mechanical thrombectomy , 702, 703 OA , 701 transcranial ultrasound , 702

Acute kidney injury (AKI) diagnosis of

AKIN criteria , 380–381 RIFLE criteria , 380

in neuroICU epidemiology of , 381 risk factors for , 381–382

prevention of , 384–385 proposed mechanism

acute tubular necrosis (ATN) , 383 acute tubulointerstitial nephritis (AIN) , 383 neuroICU-specifi c , 384 neurologic injury , 383 postrenal AKI , 383–384 prerenal AKI , 382–383

treatment of conservative management , 385 renal replacement therapy ( see renal replacement therapy)

Acute liver failure , 419–420, 750 Acute peritoneal dialysis , 386 Acute periventricular infarction , 826 Acute physiology and chronic health evaluation (APACHE) , 935 Acute purulent (bacterial) meningitis , 102 Acute respiratory distress syndrome (ARDS)

airway management , 200 high-frequency oscillatory ventilation , 227 leukopenia , 328 mechanical ventilation , 217 organ dysfunction , 418 pulmonary shunt , 229

Acute tubular necrosis (ATN) , 383 Acute tubulointerstitial nephritis (AIN) , 383 Adrenocorticotropic hormone (ACTH) , 295 Advanced cardiac life support (ACLS) , 150, 151, 744 Advanced trauma life support (ATLS) , 620 Agency for healthcare research and quality (AHRQ) , 11 AICA. See Anterior inferior cerebellar artery (AICA) Airway management

complications of desaturation , 173 esophageal intubation , 174 hemoglobin desaturation , 173 hypoxemia , 173 mainstem bronchus intubation , 175 multiple intubation attempts , 175 preoxygenation , 173 regurgitation and aspiration , 174–175

hemodynamic response bradycardia and cardiac arrest , 176–177 hyperdynamic , 175–176 hypotension , 176

hypoxia and hypercapnia respiratory acidosis , 168 secondary CNS injury , 168–169 tissue oxygen delivery (DO 2 ) , 168 ventilation , 168

in neuro ICU in acromegalic patient , 203 ASA algorithm , 177, 178 aspiration prophylaxis , 179 bag-valve-mask ventilation ( see Bag-valve-mask ventilation) carotid endarterectomy (CEA) , 203 CNS trauma , 200–201 diffi cult airway management ( see Diffi cult airway

management) effective mask ventilation , 179–181 endotracheal intubation ( see Endotracheal intubation) head frame , 203 intracranial vascular procedure , 202 laryngoscopy ( see Laryngoscopy)

966

Airway management ( cont .) neuromuscular disease , 204 patient preparation , 177–179 pediatric neurosurgical patient , 204 soft tissue collapse , 180–182 spinal cord injury , 201–202

organized treatment algorithm airway-compromising conditions , 169–171 bag-valve-mask (BVM) , 171–172 emergent/urgent airway management , 169, 171 laryngeal classifi cation , 171, 173 Mallampati classifi cation , 169, 172, 173 preoperative airway examinations , 169, 170 thyromental distance (TMD) , 171

Airway pressure release ventilation (APRV) , 226–227 AKI. See Acute kidney injury (AKI) Albendazole

echinococcal disease , 493 neurocysticercosis , 492

Altered cerebral autoregulation , 418 Altered mental status

ARAS , 522–523 brain death evaluation , 536–537 chemistries , 529–530 clouding of consciousness , 522 coma , 522 complete blood count , 529 confusional state , 522 critical illness

coma , 412–413 delirium , 410–412

disease specifi c treatment delirium , 531 demyelinating disease , 533–534 epileptiform ( see Epilepsy) intoxication ( see Intoxication) intracranial hypotension , 535 intraparenchymal hemorrhage , 532–533 ischemic stroke , 532 neoplasm , 533 PRES , 533 SAH , 533

lethargy , 522 neurodiagnostics

electroencephalogram , 530–531 evoked potentials , 531 lumbar puncture , 530

neuroimaging computed tomography , 530 magnetic resonance imaging , 530

obtundation , 522 physical examination and evaluation

abdominal examination , 524 abnormal breathing pattern ( see Respiratory pattern) cardiac/carotid examination , 523 general , 523 neurological ( see Neurological examination) pulmonary examination , 523 skin/nail examination , 524

stupor , 522 Alzheimer disease (AD) , 275 Amantadine , 275 American association of neurological surgeons (AANS) , 12 American board of medical specialties (ABMS) , 20 American heart association (AHA) , 696 American stroke association (ASA) , 247, 696 Aminoglycosides , 374, 375

Amiodarone induced thyrotoxicosis (AIT) , 312 Amoebic meningoencephalitis , 489 Amphotericin B , 375 Amplitude-integrated EEG (aEEG) , 766 Amyloid angiopathy , 824 Analgesics

NSAIDs , 949–950 opioids , 948–949

Anemia autoimmune hemolytic anemia

aplastic crisis , 327 blood transfusion , 326 cold reactive antibodies , 325–256 G6PD defi ciency , 326 paroxysmal nocturnal hemoglobinuria , 327 thrombotic microangiopathy , 326–327

blood transfusion , 322 classifi cation of , 322 in critical illness , 323 diagnostic tests , 322 in neurologically critically ill patients , 323–324 SCD ( see Sickle cell disease [SCD])

Aneurysmal subarachnoid hemorrhage (SAH) cocaine , 542 complication of

blood transfusion , 557–558 cardiac and pulmonary complication , 556–557 hyponatremia , 558

contrast prophylaxis , 545–546 diagnostic imaging techniques

cerebral angiogram , 545 CT angiography , 543, 545 intracranial aneurysms , 543, 545 magnetic resonance imaging , 545 presentation , 542 vs. traumatic tap , 544–545

endovascular therapy , 541 genetic syndrome , 542 history of , 542 stabilization and management

antifi brinolytics , 547 beta-blockers , 547 Fisher score , 543 Hunt-Hess classifi cation , 546 hydrocephalus , 548 seizures , 547–548 systolic blood pressure , 547 WFNS grade , 546

treatment method cerebral vasospasm ( see Cerebral vasospasm) endovascular treatment , 550 surgical treatment , 548–550 vasospasm prophylaxis ( see Vasospasm prophylaxis)

Aneurysms berry , 98 cerebral

anesthesia induction , 852 blood pressure and heart rate , 852 Fisher grade scale , 851 Hunt Hess grading scale , 851 perfusion pressure , 852, 853 rebleeding , 851–852 vessel rupture and hemorrhage , 852 WFNS , 851

circle of Willis , 98 defi nition of , 98 fusiform , 98

Index

967

infective/mycotic aneurysms , 98 saccular , 98

Anosognosia , 77 Anterior cerebral artery (ACA) , 51–52 Anterior cervical discectomy and fusion

(ACDF) , 865 Anterior inferior cerebellar artery (AICA) , 58, 61–62 Anterior perforated substance (APS) , 44, 45 Antiepileptic drug (AED)

barbiturates , 955 benzodiazepines , 809 drug dosing and monitoring , 954 epilepsy surgery , 810–811 lacosamide , 955–956 levetiracetam , 955 phenytoin and fosphenytoin , 809, 954–955 status epilepticus

gabapentin , 810 lacosamide , 810 levetiracetam , 810 valproic acid/depacon O , 810

Apolipoprotein E (APOE) , 567 Arginine vasopressin (AVP) , 295 Arrefl exic/lower motor bladder , 675 Arterial blood gas (ABG) , 580 Arterial spin labeling (ASL) , 824 Arteriovenous malformations (AVMs) , 852, 854

acute evaluation algorithm , 581, 582 arterial blood gas , 580 cerebral perfusion pressure , 580–581 clinical presentation , 580 electrolyte abnormability , 581 external ventricular drain , 581 factor IX defi ciency , 580 fresh frozen plasma , 580 Glasgow Coma Scale , 580 intracranial pressure , 580–581 Kellie-Monroe hypothesis , 581 mechanism of , 581 OAC therapy , 580 prothrombin complex concentrates , 580 size , 581 subendocardial ischemia , 581 triple H therapy , 581

anesthesia , 583–584 defi nition , 579 epidemiology , 579–58 grading/surgical management

endovascular embolization , 585–586 microsurgical resection , 586–587 Spetzler-Martin grading system , 585 stereotactic radiosurgery , 586

intraoperative/postoperative care , 587 radiographic imaging

artery aneurysm, lateral view , 583, 585 catheter angiography , 583, 584 imaging modality , 583 intraparenchymal hemorrhage , 583 intraventricular hemorrhage , 583, 584 ischemic vs. hemorrhagic stroke , 583 subarachnoid hemorrhage , 583, 584

Spetzler-Martin grading system , 585 Ascending reticular activating system (ARAS) , 522–523 Assist control ventilation (ACV) , 17, 226 Atelectrauma , 43–44, 234–236 Atrial fi brillation (AF) , 265

Auerbach’s/Meissner’s plexus , 675 Autoimmune hemolytic anemia (AIHA)

aplastic crisis , 327 blood transfusion , 326 cold reactive antibodies , 325–256 G6PD defi ciency , 326 paroxysmal nocturnal hemoglobinuria , 327 thrombotic microangiopathy , 326–327

Autonomic dysrefl exia , 673–674

B Babinski sign , 73, 76 Bacterial meningitis , 821, 823

clinical manifestations , 434–435 complications , 445–446 defi nition , 430 diagnosis

C-reactive protein (CRP) , 439 encephalitis , 436 fever and altered mental status , 437–438 imaging studies , 439–443 lumbar puncture and CSF analysis , 437–439 PCR assays , 439

epidemiology E. coli K1 strains , 432 H. infl uenza , 431 Listeria monocytogenes , 431–432 N. meningitides , 431 Streptococcus agalactiae , 432 Streptococcus pneumonia , 430–431

meningeal invasion complement factor C5 defi ciency , 433 H. infl uenzae , 433–434 increased intracranial pressure , 434 infl ammation , 434 outer membrane proteins , 433 polysaccharide capsule , 433 respiratory tract colonization , 432–433 S. pneumoniae , 434 virulence factors , 433

seizures , 446 treatment

blood-brain barrier , 441 community-associated meningitis , 442 dexamethasone , 443, 445 duration of , 445

vaccination , 447 Bag-valve-mask ventilation , 152

combituber use, diffi cult airway , 198 laryngeal mask airway (LMA) ( see Laryngeal mask

airway (LMA)) rigid fi beroptic laryngoscope and retrograde

intubation , 199 transtracheal jet ventilation (TTJV) , 199 transtracheal ventilation , 198–199

Barbiturates , 287 Barotrauma , 44–45 Bartonellosis , 501–502 Benzodiazepine , 285–288, 312 Bioelectrical impedance analysis (BIA) , 397 Biphasic positive airway pressure (BIPAP) , 27 Blastomycosis

clinical manifestations , 479 diagnosis , 479 pathogenesis , 478–479 treatment , 479

Index

968

Blood pressure management CNS ( see Central nervous system (CNS)) EMS , 242 neurological emergencies

agent choice , 245 AIS , 247 eclampsia , 251 HE , 251 ICH , 245–247 SAH ( see Subarachnoid hemorrhage [SAH]) spinal cord injury , 251 traumatic brain , 250

physiology and pathophysiology autoregulation , 242–243 CPP and ICP , 243 neural mechanism , 242

Bone marrow aplasia , 328 Brain

abscess , 102 clinical manifestations , 458–459 diagnosis , 459–460 incidence , 456 microbiology , 457–458 pathogenesis , 457 treatment , 460–461

brainstem medulla , 53, 54 midbrain , 40, 44, 48, 53–55 pons , 53, 54, 56, 57 pontomedullary sulcus , 53, 54 reticular formation , 54–55

functional organization brainstem , 78 frontal lobe , 75 myopathies , 80 neuromuscular junction , 80 occipital lobe , 77–78 parietal lobe , 76–77 peripheral nerves , 79 spinal cord , 78–79 temporal lobe , 76

herniation ascending herniation , 832 clinical history , 830–831 subarachnoid hemorrhage , 839 subfalcine herniation , 831 tonsillar herniation , 832–833 transtentorial herniation , 831–832 uncal herniation , 832

Brain death. See also Organ donation brain stem refl exes

apnea study , 902–903 corneal refl exes , 902 ocular testing , 902 pharyngeal and tracheal refl exes , 902 pupillary response , 901–902

consent, organ donation , 904–905 declaration of

cardiac arrest , 900 EEG results , 900 Harvard criteria , 900 Quality Standards Subcommittee of the American

Academy of Neurology , 901 exclusions and contraindications , 903–904

physical examination , 901 physiology

catecholamines , 897–898 coning , 897, 898 C-reactive protein , 900 Cushing’s triad , 896 endocrine dysfunction , 899 hemodynamic abnormalities , 899 hormone resuscitation therapy (HRT) , 897 Hunt–Hess SAH , 897 hyperdynamic–hemodynamic response , 898 hyperprolactinemia , 897 ischemia–reperfusion (IR) injury , 899 plasma interleukin-6 levels , 900 thyroid hormone defi ciency , 899

Brain natriuretic peptide (BNP) , 687 Brainstem auditory evoked potentials (BAEPs) , 115–116 Brain tissue oxygen (PbtO 2 ) monitoring

clinical application , 136 defi nition , 134 Licox monitor , 135 measurement , 135 neurocritical care unit , 134–135

Brain tumor-associated coagulopathy , 338 Brain tumors

diffuse astrocytomas , 99 glioblastoma , 99–100 gliomas , 99 medulloblastoma , 101 meningiomas , 100–101 metastatic tumors , 101 oligodendrogliomas , 100 schwannomas , 101

Broca’s aphasia , 75 Brodmann’s cytoarchitectonic map , 66, 67 Brown-Sequard syndrome , 78, 669

C Cardiac complications

brain and heart cardiac death , 256 CBN , 260 fMRI , 256 intrinsic cardiac nerve , 256 ischemic cardiac insult , 256 myocardial stunning , 256 psychological stress , 256 tauopathies , 275 TLVAB , 260 violent assault , 260

degenerative neurological diseases and heart synucleinopathies ( see Synucleinopathies) tauopathies , 275

muscular dystrophies , 275 neurologic disease and heart

dermatomyositis and polymyositis , 270 epilepsy ( see Epilepsy) GBS , 269 ICH , 267 myasthenia gravis , 269–270 PRES , 267 SAH , 262–263 spinal cord injury , 268–269

Index

969

stroke ( see Stroke) TBI , 267–268

Cardio-circulatory syndromes , 276 Cardiopulmonary resuscitation (CPR) , 755 Carotid endarterectomy (CEA) , 203, 854 Catheter-associated urinary tract infections (CA-UTI) , 15 Cat scratch disease , 501–502 CBF. See Cerebral blood fl ow (CBF) Central nervous system (CNS)

amoebic meningoencephalitis , 489 astrocytes , 92 axoplasmic constituents , 92 bacterial meningitis ( see Bacterial meningitis) brain abscess

clinical manifestations , 458–459 diagnosis , 459–460 incidence , 456 microbiology , 457–458 pathogenesis , 457 treatment , 460–461

cytoplasmic swelling , 90 ependyma and choroid plexus , 92 external ventricular drainage , 466–467 focal/diffuse hypoxia/ischemia , 90 fungal infections ( see Fungal CNS infections) HIV infection ( see Human immunodefi ciency virus (HIV) infection) human bartonellosis , 501–502 human ehrlichiosis , 501 injury

acute ischemic stroke , 241 ICH ( see Intracerebral hemorrhage (ICH)) pressor response , 241 subarachnoid hemorrhage , 241 traumatic brain injury , 241

Lyme disease ( see Lyme disease) microglia , 92 Mycobacterium mucogenicum , 473 mycobacterium tuberculous infections

spinal tuberculosis , 472–473 tuberculoma , 471–472 tuberculous meningitis , 467–471

oligodendrocytes , 92 parasitic infections ( see Parasitic infections, CNS) progressive multifocal leukoencephalopathy , 503–505 Rickettsial disease , 500–501 routes of , 429–430 spinal epidural abscess

incidence , 461 microbiology of , 462 pathophysiology , 461–462 risk factors , 462 treatment , 462–463

subacute sclerosing panencephalitis (SSPE) , 503 synaptophysin , 90 syphilis ( see Syphilis) tumors

anti-angiogenic agents , 714 brain metastases , 709–710, 717–718 chemotherapy , 714–716 diagnosis , 710–712 ependymoma , 718–720 epidemiology , 708 gliomas , 708–709, 716 HGGs , 716

intracranial germ cell tumors , 720, 723 LGGs , 716–717 medulloblastoma/PNET , 720–722 meningioma , 720, 721, 724 pituitary adenomas , 722, 725–726 presentation of , 710 radiation therapy , 713–714 radiographic evaluation , 710 surgery , 713 vestibular schwannoma , 722, 725

vertebral osteomyelitis incidence , 463 microbiology of , 464 pathogenesis , 464 risk factors , 463–464 treatment , 466

Whipple’s disease , 502–503 Central pontine myelinolysis (CPM) , 806 Central venous pressures (CVPs) , 581 Cerebellar tonsils , 833 Cerebral abscesses , 534–535 Cerebral amyloid angiopathy (CAA) , 567 Cerebral aneurysms

anesthesia induction , 852 blood pressure and heart rate , 852 Fisher grade scale , 851 Hunt Hess grading scale , 851 perfusion pressure , 852, 853 rebleeding , 851–852 vessel rupture and hemorrhage , 852 WFNS , 851

Cerebral autosomal dominant arteriopathy with subcortical infarcts (CADASIL) , 98

Cerebral blood fl ow (CBF) , 283, 683, 696 intraoperative neuroanesthesia

cerebral hyperemia and ischemia , 846 mean arterial pressure , 845–846 neural autoregulation , 845–846 oxygenation and pH , 845 patient preparation , 846–847 white and gray matter , 845

invasive intracranial monitoring bioinformatics , 139–140 cerebral perfusion , 138 classifi cation , 138 laser Doppler fl owmetry , 138 metabolism measurement , 137–138 thermal diffusion , 139

noninvasive monitoring modalities cerebral ischemia , 116–117 indicator dilution method , 117 laser Doppler fl owmetry , 122 thermal diffusion fl owmetry , 121–122 transcranial Doppler ( see Transcranial Doppler [TCD])

Cerebral blood volume (CBV) , 683, 696 Cerebral herniation

central , 94 cerebellar tonsillar herniation , 94 cingulate , 94 Duret hemorrhages , 94 transcalvarial , 94 transtentorial , 93–94 uncal , 94

Cerebral hyperglycolysis , 137

Index

970

Cerebral microdialysis (CMD) clinical application , 136–137 defi nition , 136 lactate classifi cation , 137 molecule measurement , 137 principles , 136 threshold values , 137

Cerebral oximetry , 123 Cerebral resuscitation

brain injury, anatomical pattern of CT scans , 755–758 MRI , 758 selective neuronal injury , 758–759

cerebral blood fl ow cerebral perfusion pressure , 760–761 CO 2 reactivity , 760 microvascular blood fl ow, heterogeneity of , 760

functional outcomes, heterogeneity of , 756 neurological monitoring, after cardiac arrest

arterial blood pressure , 765 EEG , 766 intracranial monitoring , 767 jugular bulb oximetry , 766–767 NIRS , 767 SSEPs , 766 TCD , 767

neurological prognostication , 769–770 non-neurological organ

acute cardiovascular interventions and hemodynamic support , 768

glycemic control , 768–769 infl ammatory and hematological changes , 769 nutritional support and electrolyte management , 769 ventilator strategies , 768

pharmacological considerations , 767–768 rehabilitation , 770–772 seizures

EEG fi ndings , 761 epileptiform discharges , 761 MSE , 761–762 NCSE , 761

TTM bladder temperature , 763 blood gas interpretation and hypothermia , 765 cold intravenous fl uids , 763 complications of , 764–765 endovascular cooling devices , 763–764 hypothermia treatment, duration of , 763 initiate hypothermia, timing of , 762–763 post-cardiac arrest care , 762 surface cooling devices , 764 therapeutic window , 762

Cerebral salt wasting (CSW) , 307, 363–365, 581, 686, 687 Cerebral sinus venous thrombosis , 337 Cerebral vasospasm

clinical evaluation of , 551 DCI/DINDs , 551 identifi cation

computed tomographic angiogram , 552 computed tomography , 551 digital subtraction angiography , 551 modifi ed Rankin scores , 551 MRI , 551 TCD , 551–552

Cerebral venous thrombosis , 834–835 Cerebrovascular disease

CADASIL , 98 cerebral amyloid angiopathy (CAA) , 97–98 global hypoxia/ischemia , 97

ischemic infarcts , 97 ischemic strokes , 97 multi-infarct dementia , 97 posterior reversible encephalopathy syndrome (PRES) , 97 regional ischemic injury , 97 systemic hypertension , 97 venous thrombosis , 97

Cerebrum basal surface

anterior perforated substance , 44, 45 arterial relationships , 45–49 neural relationships , 44, 45 venous relationships , 45, 46

lateral surface amygdala , 40, 42 arterial relationships , 43–45 basal ganglia , 37, 38, 41 choroidal fi ssure , 38, 40, 42 corpus callosum , 40, 41 foramen of monro , 38–40 frontal lobe , 35–36 hippocampus , 40, 42 internal capsule , 38, 41 lateral parietotemporal line , 34, 35 lateral ventricles , 38–40 occipital lobe , 35–37 parietal lobe , 35, 36 sylvian fi ssure , 36–39 temporal lobe , 35, 36 thalamus , 37, 38, 40–42 third ventricle , 40, 42–43 venous relationships , 38, 40, 43, 44

medial surface arterial relationships , 44, 51–52 neural relationships , 49–51 venous relationships , 51

vascularization of , 50, 52, 53 Chiari 1 malformation , 833 Chronic infl ammatory demyelinating polyneuropathy (CIDP) , 269 Cimetidine , 374 Clevidipine , 245 CMD. See Cerebral microdialysis (CMD) Coagulopathy

brain tumor-associated , 338 in emergent neurosurgery , 337–338 spontaneous and induced

anti-coagulation vs. spontaneous ICH , 335–336 cerebral sinus venous thrombosis , 337 cryptogenic stroke , 335 intraventricular hemorrhage , 336–337 ischemic stroke with hemorrhagic transformation , 335 stroke , 334–335

in traumatic brain injury , 337 Coccidioidal meningitis

pathogenesis , 377–378 treatment , 478

Coma biological origin of , 412 characteristics of , 412 etiologic categories of , 412 FOUR score , 412, 413 Glasgow coma scale (GCS) , 412 metabolic encephalopathy causes , 412, 413 neurotransmitters , 412 physical signs in , 412, 413

Commission on professional and hospital activities (CPHA) , 13

Committee on manpower of pulmonary and critical care societies (COMPACCS) , 22–23

Index

971

Competency based training program in intensive care medicine for Europe (CoBaTrICE) , 21

Complete blood count (CBC) , 529, 697 Complete metabolic panel (CMP) , 697 Complex spine surgery

anterior lumbar spine approach , 645–646 anterior thoracic spine approach

drill/oscillating saw , 645 Horner’s syndrome , 645 retropleural/intrapleural exposure , 645 rostral-caudal segment , 644 thoracotomy , 645 trans-clavicular approach , 645 trans-manubrial approach , 645 T-shaped incision , 645

clinical application of deformity ( see Spinal deformity) infection ( see Spinal infection) spinal neoplasm ( see Spinal neoplasm) spinal trauma ( see Spinal trauma)

neurocritical care , 644 posterior ventral thoracic approach , 646–647 posterior ventral thoracolumbar spine

approach , 646–647 spinal instrumentation ( see Spinal instrumentation)

Computed tomographic angiography (CTA) , 349 cerebral vasospasm , 552 ICH , 569

Computed tomography (CT) cerebral vasospasm , 551 ICH , 568–569 neuroradiological imaging

angiography and perfusion , 829–830 clinical application , 829 intravenous contrast agent , 829

neurorehabilitation , 883 pediatrics

acute subdural hematoma , 605, 606 cerebral edema , 605 convex hyperdensity posterior , 605 epidural hematomas , 605 intraparenchymal hemorrhages , 605 large scalp laceration , 605, 606 management protocols , 605 motor vehicle collision , 605, 607 subdural/multifocal extra-axial

hematomas , 605 Confusion assessment method , 410 Continuous positive airway pressure

(CPAP) , 27 Continuous renal replacement

therapies (CRRT) , 386 Contraction-band necrosis (CBN) , 260 Controlled mandatory ventilation (CMV) , 17 Cortico-basal degeneration (CBD) , 275 Corticosteroids , 950 Corticotropin-releasing hormone (CRH) , 295 Cranial nerves

abducens nerve , 69, 71 facial nerve , 69, 71 glossopharyngeal nerve , 70, 72 hypoglossal nerve , 71 oculomotor nerve , 68, 69 olfactory nerve , 66–68 optic nerve , 67–69 physical examination and evaluation

ARAS fi ber , 525 blown pupil , 526 CNS lesion , 525

corneal refl ex , 527 “doll’s eyes” maneuver , 527 Edinger-Westphal nucleus , 526 gag refl ex , 527 Horner’s syndrome , 526 imaging technique , 526 oculomotor function , 526 pupillary response , 525 syphilis , 527 transtentorial herniation syndrome , 526 vestibulo-ocular refl ex , 527

spinal accessory nerve , 70, 74 trigeminal nerve , 69, 70 trochlear nerve , 68–70 vagus nerve , 70, 73 vestibulocochlear nerve , 70

Cranial vault bifrontal craniectomy , 740 DHC and duraplasty , 739–740 mass lesions, evacuation of , 739

Creatinine phosphokinase (CK-MB) , 263 Creutzfelt-Jacob disease (CJD) , 103 Critical illness

altered mental status coma , 412–413 delirium , 410–412

ICU-acquired weakness critical illness myopathy (CIM) , 415 critical illness neuromyopathy (CINM) , 416 critical illness polyneuropathy (CIP) , 415 vs. Guillain-Barré syndrome , 416 mechanical ventilation , 416 MRC score , 416

long-term cognitive impairment , 414–415 medications, in ICU

antibiotics , 416 immune suppressants , 416–417 sedatives , 416

posterior reversible encephalopathy syndrome , 414

seizures and status epilepticus , 413, 414 sleep disorders and sleep deprivation , 414

Critical illness myopathy (CIM) , 415 Critical illness polyneuropathy

(CIP) , 415 Cryptococcus meningitis

C. neoformans , 473–474 diagnosis , 474–475 treatment of , 475

D Dalteparin , 347 D -dimer assay , 349 Deep vein thrombosis (DVT) , 703

diagnosis , 349 treatment , 349–351

Delayed cerebral ischemia (DCI) , 551 Delayed ischemic neurologic defi cits

(DINDs) , 551 Delirium

CAM-ICU , 410 ICDSC , 410 incidence of , 410 medications , 6–7 non-pharmacologic management , 410, 412 pathogenesis of , 410

Dexmedetomidine (DEX) , 286–288 Diabetes insipidus (DI) , 367, 687–688

Index

972

Dialysis disequilibrium syndrome , 421 Diffi cult airway management

cannot intubate , 189–190 cannot ventilate, cannot intubate (CVCI)

combituber ® , 191–192 emergency tracheostomy , 192–193 hemoglobin desaturation , 190 laryngeal mask airway (LMA) placement , 190–191 needle cricothyroidotomy , 194–195 percutaneous cricothyroidotomy , 193–194 supraglottic device , 192 transtracheal catheter ventilation , 51–53

diffi cult airway cart (DAC) , 212–213 extubation of

AEC-assisted extubation , 205–206 biofi lm management , 209 cervical spine surgery/trauma , 208 “cuff-leak” test , 205 dislocation, ETT , 211–212 endotracheal tube exchange , 210–211 indwelling duration , 207–208 in neuroICU , 208 phases of , 204, 205 post-extubation oxygen supplementation , 206–207 risk factors , 204 tracheostomy , 209–210 VL evaluation , 205

pediatric , 213 prediction strategy

FOB , 187 glottic and trachea anesthesia , 188 H2 blockers administration , 187 laryngotracheal atomizer , 188 lidocaine , 188 nasotracheal intubation , 189 Parker FlexTip ETT™ , 188 silicon diaphragm , 187

training issues , 213 Diffusion-weighted imaging (DWI) , 824, 826 Digital subtraction angiography (DSA)

cerebral vasospasm , 551 ICH , 570–571

Digoxin , 375 Disodium edetate (EDTA) , 284 Disorders of consciousness (DOC)

coma , 879 Klüver-Bucy syndrome , 881 minimally conscious state , 880 Parkinsonian and cerebellar symptoms , 881–882 pathological postures , 881 posttraumatic mutism , 882 posttraumatic psychomotor agitation , 880–881 severe brain injury , 880 vegetative state , 879–880

Dopamine (DA) , 275, 312 Dressing apraxia , 77 Drug intoxication

nonrecreational drug-induced seizures , 807–808 analgesics , 808 antibiotics , 809 antidepressants , 808 antipsychotics , 808 central anticholinergic syndrome , 808 isoniazid (INH) , 809 methylxanthines , 808–809 serotonin syndrome , 808

recreational drug-induced seizures , 807

Duchenne muscular dystrophy (DMD) , 275 Duret hemorrhages , 94 DVT. See Deep vein thrombosis (DVT) DWI. See Diffusion-weighted imaging (DWI) Dysglycemia

BBB , 298 glucose management , 298 GLUT3 , 298 insulin therapy , 298 Krebs cycle , 298 microcatheter , 298 microdialysis , 298 NICE SUGAR trial , 298

E Ehler-Danlos syndrome , 542 Ehrlichiosis , 501 Electroencephalography (EEG) , 766, 800

burst suppression , 112, 113 clinical application

brain death , 114 monitoring , 112–114 sedation , 114–115

drug effects , 112 electrodes , 111–112 epileptiform , 801 indications , 800 NCSE , 800, 801

Emergency medical services (EMS) , 150–151 Encephalitis, CNS infection. See Viral meningitis

and encephalitis Endocarditis , 417 Endocrine abnormality

acute phase effector protein level , 299 low T3 syndrome , 299

brain death decreased cortisol level , 314 hyperglycemia , 314 TSH defi ciency , 314

chronic phase deiodinase , 300 hypercortisolism , 300 wasting syndrome , 300

drug-induced disorder adrenal abnormality , 310–312 glucose , 313–314 thyroid hormone abnormality , 312–313

dysglycemia , 294, 297–298 endocrine secreting tumors ( see Endocrine secreting tumors) GBS , 302–303 hormonal therapy , 309–310 HPA ( see Hypothalamic-pituitary axis [HPA]) low T3 syndrome

cortisol , 299 metabolic shutdown , 299

meningitis/encephalitis , 303–305 mental status

adrenal dysfunction , 310 hyper and hypoglycemia , 310 hypothyroidism , 310

neurotransmitters , 294 stroke , 301 target cells , 294 traumatic brain injury and adrenal

insuffi ciency , 301–302

Index

973

Endocrine secreting tumors craniopharyngiomas

analysis of , 307 symptoms , 308 treatment of , 308

meningiomas hormonal therapy , 309 premenopausal and postmeopausal women , 309

pituitary tumors ketoconazole , 306 macroadenoma , 305 management of , 307 microadenoma , 305 signs and symptoms , 305 treatment of , 306

Endothelin receptor antagonists (ERA) , 553–554 Endotracheal intubation

detected esophageal misplacement, management of , 196 esophageal bulb detector device (EDD) , 195–196 exhaled CO 2 detection , 196 oxygen saturation , 196 visual inspection of , 195

Enoxaparin , 347 Epidermal growth factor receptor (EGFR) , 712 Epilepsy

convulsive status epilepticus , 535 immune mediated encephalopathy , 535–536 murine study , 271 NCSE , 535 neurocysticercosis , 489–490 neuronal damage , 271 SE , 270 sedation use , 282 SUDEP , 272

Erythrocytosis complications , 332 defi nition , 332 polycythemia vera (PV) , 333

Ethical issues ATS position , 922 decisional capacity , 923–924 end-of-life issues ( see Life-sustaining treatment [LST]) end-stage renal disease , 921 explicit specifi cation , 922 fairinnings argument , 922 Jehovah’s witnesses , 920–921 macroallocation , 921 microallocation , 921 principles of , 920 prognostic scoring systems , 923

Etomidate , 310 European Union Of Medical Specialists (UEMS) , 21 Evoked electrical activity

brainstem auditory evoked potentials , 115 clinical application , 116 motor evoked potentials , 116 somatosensory and auditory stimulation , 115 somatosensory evoked potentials , 116 visual evoked potentials , 115

External ventricular drain (EVD) , 130, 466–467, 581 Extracorporeal life support (ECLS) , 35, 36 Extrapyramidal disorders , 72

F Fludricortisone , 275 Fluoroquinolone , 52

Follicle stimulating hormone (FSH) , 295 Fondaparinux , 345 Forced vital capacity (FVC) , 782 Fresh frozen plasma (FFP) , 580 Fronto-temporal dementia (FTD) , 275 Full-time equivalent (FTE) , 5 Functional electrical stimulation (FES) , 672 Functional magnetic resonance imaging (fMRI) , 256 Fungal CNS infections

Aspergillus species , 481 blastomycosis

clinical manifestations , 479 diagnosis , 479 pathogenesis , 478–479 treatment , 479

Candida CNS infections , 479–480 coccidioidal meningitis

pathogenesis , 377–378 treatment , 478

cryptococcus meningitis C. neoformans , 473–474 diagnosis , 474–475 treatment of , 475

fungal meningitis , 473 histoplasmosis , 476–477 zygomycetes and zygomycosis , 480–481

G Gabapentin , 805 Gamma-aminobutyric acid (GABA) , 282, 806 Gamma hydroxybutyric acid (GHB) , 532 GBS. See Guillain-Barré syndrome Germ cell tumors (GCTs) , 720 Gerstmann’s syndrome , 66, 77 Glascow Coma Scale (GCS) , 24, 110–111, 412, 524–525, 580 Glial fi brillary acidic protein (GFAP) , 710 Gliomas , 716 Glucose transporter 3 (GLUT3) , 298 Goal-directed therapy , 131 Gonadotropin , 297 Gradient-recalled echo (GRE) sequence , 821, 823–825 Graduated compression stockings (GCS) , 346–347 Growth hormone (GH) , 295 Growth hormone releasing hormone (GHRH) , 295 Guillain-Barré syndrome (GBS) , 784

atropine , 269 Campylobacter jejuni , 302 CIDP , 269 conivaptan , 307 electrocardiographic changes , 269 HT , 303 hyponatremia , 303 paresthesias , 302 treatment of , 302

H Hashimoto’s thyroiditis (HT) , 303 Hematologic disorders

brain tumor , 338 coagulopathy ( see Coagulopathy) decreased blood count

anemia ( see Anemia) leukopenia ( see Leukopenia) thrombocytopenia ( see Thrombocytopenia)

incidence of , 321

Index

974

Hematologic disorders ( cont .) increased blood count

erythrocytosis , 332–333 leukocytosis , 334 thromboytoses , 333–334

Heparin-induced thrombocytopenia (HIT) , 331 Hepatic encephalopathy , 420 Heterotopic ossifi cation (HO) , 677–678 High frequency oscillatory ventilation

(HFOV) , 24 High grade gliomas (HGGs)

anti-angiogenic agents , 716 RT , 716

Histoplasmosis , 476–477 Hoffman twitching , 73, 77 Homonymous hemianopia , 77 Horner’s syndrome , 526, 645 Human immunodefi ciency virus (HIV) infection

cytomegalovirus cell-mediated immunity , 485 diagnosis , 485–486 treatment , 486

encephalopathy and dementia , 486–487 Toxoplasma gondii

clinical manifestation , 482 diagnosis , 482–484 in Europe , 482 treatment , 484–485 in United States , 481–482

Hydrocephalus , 93–94, 468, 837, 838 Hydrotherapy , 885–886 Hyperalimentation (HAL) , 401 Hyperkalemia

causes of , 372 clinical manifestation , 372 management of , 372

Hypernatremia clinical manifestation , 366 diabetes insipidus (DI) , 367 in neurointensive care unit , 366–367 polyuric patient management

indomethacin , 370 intake and output documentation , 370 thiazide , 370

total body water (TBW) , 367–368 volume replacement , 367

Hypertension , 418 Hypertensive encephalopathy (HE)

magnetic resonance imaging , 251 nitroprusside , 251

Hypertonic saline (HTS) treatment , 595 Hypoglycemia , 159 Hypokalemia , 372–373 Hyponatremia

cerebral salt wasting (CSW) , 363–365 diagnostic workup

ADH level , 361 central venous pressure (CVP) , 360–361 diagnostic protocol , 361, 362 physical exam (PE) , 360 in SAH , 361

evaluation of , 359–360 mortality rates , 359 SIADH , 363 treatment of , 361, 363

Hypothalamic-pituitary axis (HPA) adenohypophysis , 294 neurohypophysis , 294

pathophysiology etiology , 295–296 management , 297 symptomatology and diagnosis , 296–297

Hypothermia application , 156–157 complications of , 155–156 induction , 154–155 maintenance of , 155 neuroprotection , 844, 845 rewarming , 155 subarachnoid hemorrhage , 157 targeted temperature management , 154 traumatic brain injury , 157

Hypoxemia , 28–31 Hypoxia , 835–836 Hypoxic vasoconstriction physiology (HPV) , 34

I ICA. See Internal carotid artery (ICA) ICP. See Intracranial pressure (ICP) ICU-acquired weakness

clinical presentation , 790 diagnosis , 790 electrophysiology , 790 genetic testing , 796 imaging , 795 laboratory testing

autoimmune and hematological testing , 794 CPK , 794 CSF testing , 794–795 demyelination related testing , 795 neuromuscular junction related testing , 795 routine testing , 794

management , 790 neurological signs

abnormal movements , 794 cranial nerve examination , 793 motor and refl ex examination , 793–794 sensory examination , 793

neurophysiology EMG , 795 H-refl ex and F-wave studies , 796 nerve conduction studies , 796

respiratory testing blood gases , 795 lung function test , 795 sniff test , 795

risk factors , 790 symptoms

autonomic , 792 cardiorespiratory considerations , 792 history , 792 sensory changes , 791–792 weakness , 791

tissue testin g , 796 vital signs and cardiorespiratory examination

airway , 792–793 breathing , 793 circulation , 793

ICU physician staffi ng (IPS) , 5 Indomethacin , 370 Inferior vena cava (IVC) fi lters , 346 Inhaled nitric oxide (iNO) , 230 Institute of medicine (IOM) , 5

patient injury , 10 quality improvement , 10

Index

975

Intensive blood pressure reduction in acute cerebral hemorrhage trial (INTERACT) , 246

Intensive care delirium screening checklist (ICDSC) , 410

Intensive care unit (ICU) , 683 history and evolution

limiting factor , 4 NIH , 3

neuroanatomy ( see Neuroanatomy) neurocritical care , 4 organization , 4–5 physician extenders , 5 physician staffi ng , 5 quality metrics

checklist , 6 data collection , 6 health care quality , 5 institute of medicine , 5

special units , 4 subspecialty

ABMS , 20 CoBaTrICE , 21 diplomates , 24 neurointerventional techniques , 23 neuromuscular diseases , 23 nursing staff , 23 OB/GYN , 21 pulmonary issues , 20 SCCM , 20 traumatically brain-injury , 23 UCNS , 24 UEMS , 21

training , 22 vasoactive agent

antihypertensive agents , 953 hydralazine , 953–954 inotropes , 951–952 labetalol , 953–954 nicardipine , 953 sodium nitroprusside , 953 vasopressors , 952

weak patients in acute poliomyelitis , 784 acute porphyria , 785–786 blood gases , 782 botulism , 787 circulation , 782–783 clinical judgment , 782 diphtheria , 788 discharge planning , 788, 789 GBS , 784–785 history , 779 hypokalemic periodic

paralysis , 788 laboratory testing , 780–781 LEMS , 786–787 lung function testing , 782 MRI , 781 myasthenia gravis , 786 neurophysiology , 781 neurotoxic fi sh poisoning , 787–788 physical examination , 779–780 PM/DM , 788 prophylaxis and maintenance , 783 respiratory testing , 781 symptomatic care , 783 synthesis , 781–782 tetanus , 788

tick paralysis , 787 tissue testing , 781 ventilation and airway protection , 782–783

workforce , 22–23 Intermittent mandatory ventilation (IMV) , 18 Intermittent pneumatic compression devices

(IPC) , 346 Internal carotid artery (ICA) , 694 International surgical trial in intracerebral haemorrhage

(STICH) , 568 Intoxication

cocaine/sympathomimetics , 531–532 GHB , 532 lysergic acid diethylamide , 532 narcotics , 532 sedatives , 531

Intracerebral hemorrhage (ICH) , 267, 323 cerebral blood fl ow , 246 cerebral edema , 247 clinical outcome , 246 clinical presentation , 567–568 diagnostics imaging technique

computed tomographic angiography , 569 computed tomography , 568–569 DSA , 570–571 MRI , 570 patient evaluation , 571 stages , 568

epidemiology , 566 INTERACT , 246 intracranial pressure , 247 medical management

blood pressure , 571, 572 cerebral edema , 571 general care , 572 hematoma expansion and rebleeding , 571 seizures , 572

morbidity and mortality , 568 peri-hematomal edema , 748 primary/secondary , 565–566 risk factor , 749

age , 566 antithrombotic medications , 567 CAA , 567 hypertension , 567 race/ethnicity , 566–567

surgical management cerebellar hemorrhage , 573–574 hydrocephalus , 574 IVH , 574 supratentorial hemorrhage , 572–573

treatment of , 566 Intracranial hemorrhage , 837–839 Intracranial pressure (ICP) , 242, 267, 284, 682

adverse effect , 128 autoregulation and cerebral energy requirements

CBF , 733 CMRO 2 , 732 CPP , 733–734 lactate/pyruvate ratios , 733 MAP , 732, 733

barbiturates , 597 BBB , 730 brain tissue oxygenation , 735 CBF , 735 cerebral edema

cytotoxic (cellular) edema , 731 interstitial edema , 731

Index

976

Intracranial pressure (ICP) ( cont .) osmotic edema , 731 vasogenic edema , 730

coma and herniation syndromes central herniation , 731 uncal herniation , 731–732 upward herniation , 732

compliance , 732 cranial vault

bifrontal craniectomy , 740 DHC and duraplasty , 739–740 mass lesions, evacuation of , 739

CSF , 733 defi nition , 580–581 EEG , 735 glucose control , 739 hemodynamic monitoring , 735 hyperventilation , 596 hypothermia , 596 ICP waveforms , 732 indications

aSAH , 734 traumatic brain injury , 734

monitoring , 594–595 indications , 129–130 intraparenchymal devices , 130–131 uses of , 130 ventricular catheter , 130

osmotherapy hypertonic saline , 595 mannitol vs. HTS , 595–596 serum osmolality and sodium , 595

paralysis , 596 prognosis , 734 reduce cerebral edema

osmotic agents , 736–737 steroids , 737

reduce cerebral metabolism barbiturates , 737 hypothermia , 737 seizure treatment and prophylaxis , 737

reduce CSF volume and CBV cerebrospinal fl uid drainage , 736 hyperventilation , 736 positioning , 736

resuscitation , 736–735 sedation/neuromuscular blockade , 738–739 steroid , 597 stimulation , 738 surgical decompression

acute subdural hematoma , 596 epidural hematoma , 596 posterior fossa lesions , 597 traumatic parenchymal hemorrhage , 596–597

techniques fl uid-coupled monitoring/ventriculostomy ,

734–735 parenchymal monitoring , 735

temperature control , 739 treatment

brain multimodality monitoring , 131–132 compliance assessment , 132 continuous multimodality monitoring , 132–133 duration , 131 goal-directed therapy , 131 management , 131 waveform , 132

Intracranial vascular procedure , 202 Intraoperative Hypothermia for Aneurysm Surgery Trial

(IHAST) , 845, 852, 859 Intraoperative neuroanesthesia

anesthesia and neuropathophysiology arterial oxygen content , 847 cerebral blood fl ow , 845–847 cerebral oxygen consumption , 844–845 fl uid and electrolyte management , 847–848 intracranial pressure , 845

craniotomy , 857 esmolol dose , 848 extubation logistics , 857–858 patient positioning , 848 perioperative care

brainstem , 850 posterior fossa surgery , 850 transphenoidal hypophysectomy , 850–851 tumors , 849–850 venous air embolism , 849 visual loss , 848–849

spine surgery , 856–857 stroke , 855–856 timing and communication , 848 vascular neurosurgery

arteriovenous malformations , 852, 854 carotid endarterectomy , 854 cerebral aneurysms , 851–852 endovascular , 854–855

Intravenous immunoglobulin (IVIg) , 785 Intraventricular hemorrhage (IVH) , 336–337 Invasive intracranial monitoring

brain oxygenation jugular venous oximetry , 133–134 tissue oxygen , 134–136

cerebral blood fl ow bioinformatics , 139–140 cerebral perfusion , 138 classifi cation , 138 laser Doppler fl owmetry , 138 metabolism measurement , 137–138 thermal diffusion , 139

cerebral microdialysis clinical application , 136–137 defi nition , 136 lactate classifi cation , 137 molecule measurements , 137 principles , 136 threshold values , 137

ICP ( see Intracranial pressure [ICP]) multimodality monitoring , 127 pathophysiology

autoregulation and cerebral perfusion pressure , 129 Monro-Kellie doctrine and compliance , 129

secondary brain injury , 127 Ion channel disease , 276 Ischemic stroke , 301 Isocitrate dehydrogenase-1 (IDH1) , 712

J Jugular venous oximetry , 122–123, 133–134

K Kluver–Bucy syndrome , 76 Kussmaul sign/hepatujugular refl ux , 523

Index

977

L Labetalol , 245 Lambert-Eaton myasthenic syndrome (LEMS) , 786–787 Laryngeal mask airway (LMA)

contraindications to , 197 disadvantages of , 57 ETT , 197–198 pre-hospital airway management , 197 ProSealr , 197

Laryngoscopy blade selection

bougie , 183 curved , 183 DL vs. VL , 184 ETT counterclockwise rotation , 183 straight , 183

optimal external laryngeal manipulation (OELM) , 182, 183 patient positioning , 182–183 video laryngoscopy

Airtraq ® , 184, 185 blades shapes , 184 Clarus ® Levitan optical airway scope , 184, 186 vs. conventional laryngoscopy , 185 device cost , 184 ETT exchange , 186 GlideScope ® , 184, 185 glottic view , 186, 187 Storz C-MAC ® , 184, 185

Laser Doppler fl owmetry (LDF) , 122, 138 Laxatives , 375 Length of stay (LOS) , 281 Leukocytosis , 334 Leukopenia

bone marrow aplasia , 328 immune and drug-related granulocytopenia , 328–329 primary bone marrow disease

acute respiratory distress syndrome (ARDS) , 328 antibiotic regimens , 327–328 fungal infections , 328 septic shock , 327

white blood cell count in , 327 Levetiracetam , 805 Lewy-body dementia (LBD) , 272 Life-sustaining treatment (LST)

advance directive CPR , 932–933 durable power of attorney , 928 empirical study , 932 goal of , 932 life decision chart , 928 limitation of , 929 patient instructions , 927 physician form , 929–931 physician’s role , 933 substituted judgment , 932 surrogate/proxy healthcare , 927 terminal illness , 933

artifi cial nutrition and hydration , 936–937 aspects of , 927 cardiac implanted electronic devices , 927 dialysis , 927 DNR order , 926 implantable cardio-defi brillator device , 927 mechanical ventilation , 926 medical futility

APACHE , 935 city-wide process , 935

imminent demise futility , 935 lethal condition futility , 935 outcomes , 935 patient autonomy , 934 patient’s quality , 934 physiological effect , 935 quantitative and qualitative futility , 934 Schneiderman’s original defi nition , 935

with organ donation , 924–925 palliative sedation , 938 perioperative DNR Status , 933–934 physician aid , 937–938 refuses , 926 voluntary dehydration , 938 without organ donation , 925–926

Lithium , 313 Liver , 804 LMWHs. See Low-molecular-weight heparins (LMWHs) Low grade gliomas (LGGs) , 716–717 Low-molecular-weight heparins (LMWHs) , 345, 347, 957 Luteinizing hormone releasing hormone (LHRH) , 295 Lyme disease

diagnosis of , 499 pathogenesis

clinical manifestations , 497–498 CSF analysis , 498 EEG and CT abnormalities , 498 intermittent tingling and paresthesia , 499 laboratory and radiographic signs , 498–499 meningitis , 498 psychological testing , 498 radicular pain and sensory changes , 499 third stage , 498

treatment , 499–500 Lymphocytic choriomeningitis virus (LCMV)

meningitis , 451 Lysergic acid diethylamide (LSD) , 532

M Magnetic resonance angiography (MRA) , 825, 827, 828 Magnetic resonance imaging (MRI) , 697, 758

angiography and venography , 825, 827, 828 cerebral vasospasm , 551 DWI , 824, 826 echo-planar sequence , 822, 824 fast spin echo/turbo spin echo , 820 gradient-recalled echo sequence , 821, 823–825 ICH , 570 intravenous contrast material , 821–822 intravenous gadolinium contrast agent , 828–829 inversion recovery , 820–821, 823 magnetic fi eld , 818 MR perfusion , 824, 827 neurorehabilitation , 883–884 pediatrics , 606 proton and radiofrequency , 818 repetition time , 819–820 spatial localization , 820 spin echo and sequences , 819, 820 T1 relaxation and T1-weighted contrast , 818–819 T2 relaxation and T2-weighted contrast , 819, 821, 822 usage restrictions , 825, 827–828

Magnetic resonance venography (MRV) , 825, 827, 828 Mask ventilation

facemask sealing , 179 lower esophageal sphincter (LES) , 180

Index

978

Mask ventilation ( cont .) pressure manometer addition , 180 sniffi ng position , 179

Maximum expiratory pressure (MEP) , 782 Maximum inspiratory pressure (MIP) , 782 Mean arterial pressure (MAP) , 845–846 Mean transit time (MTT) , 696 Mechanical ventilation (MV)

complications of VAP , 46–48 VIDD , 48–49 VILI ( see Ventilator-induced lung

injury [VILI]) conventional ventilation

ACV , 17–18 CMV , 17 control and support modes , 16 dual control ventilation , 22–23 IMV , 18–19 PSV , 19–21 SIMV , 19

hypoxemia , 29–31 mode of ventilation

APRV , 23–24 HFOV , 24 NAVA , 25 NIV , 26–28 PAV , 25–26

NPV , 13 oxygenation

adjunctive and rescue therapy, hypoxemia , 34–36 hypoxia , 29–31 PEEP , 32 recruitment maneuvers (RM) , 33 shear trauma , 32

PEEP , 16 PPV , 13–15 respiratory system (RS) physiology

defi nition , 4 distribution of , 8 driving pressure , 4 dysfunction , 12 function of , 67 gas exchange , 11–12 gravitational and non-gravitational forces , 9 lung compliance , 5 lung volume , 6 minute ventilation (V E ) and dead space , 7–8 ventilation distribution , 9–11

volume vs. pressure control , 15–16 weaning

modes , 39 predictors , 38–39 SBT , 39–42

Melanoma metastasis , 819, 820 Meningioma , 720, 721, 724 Meningitis , 534

bacterial ( see Bacterial meningitis) diagnosis of , 304 fungal , 473 management of , 304 retrospective study , 304 viral ( see Viral meningitis and encephalitis)

Metabolic encephalopathy , 421 Millard-Gubler syndrome , 78 Minimally conscious state (MCS) , 880 Modifi ed Ashworth Scale (MAS) , 676, 677

Monro-Kellie doctrine states , 129 Motor evoked potentials (MEPs) , 116 Motor function

coordination tests , 72 extrapyramidal disorders , 72 lower motor neuron disorders , 72, 76 motor homunculus , 71, 74 neuromuscular junction disease , 72 polymyositis , 72 upper motor neuron disorders , 71–72, 75

Multiprofessional team cost differential , 25 discharge disposition , 24 knowledge-based and United Council , 24, 25 multivariate analysis , 26 NCS , 27 neurocritical care team , 26 online survey , 27 patient outcome , 27 protocol-driven therapy , 27 quality issues , 22

Multi-system atrophy (MSA) , 272 MV. See Mechanical ventilation (MV) Myasthenia gravis (MG) , 269 Mycobacterium tuberculous infections

spinal tuberculosis , 472–473 tuberculoma , 471–472 tuberculous meningitis

clinical presentation , 468–469 diagnosis , 469–470 vs. HIV infection , 467–468 pathogenesis , 468 prognosis and sequelae , 471 treatment , 470–471

Myeloproliferative disorders (MPD) , 332 Myoclonic status epilepticus (MSE) , 761–762

N National Cancer Institute of Canada (NCIC) , 716 National Institute of Health (NIH) , 3 National Institute of Heath Stroke Scale

(NIHSS) , 696, 697 National quality forum (NQF) , 12 Near-infrared spectroscopy (NIRS) , 767 Nervous system

bilateral bitemporal fi eld cut , 83 brain ( see Brain) central cord syndrome , 85 neurological examination

cranial nerves ( see Cranial nerves) mental status , 66, 67 motor function , 71–72, 74–76 refl exes , 72–73 sensation , 73, 75, 77–80

Parinaud’s syndrome , 78 right central seventh nerve paralysis , 81 right sided decrebration , 82 Tinel’s sign , 87 trigeminal neuralgia , 86 vitamin B12 defi ciency , 86

Neurally adjusted ventilatory assist (NAVA) , 25 Neuroanatomy

adult central nervous system , 34 brainstem

medulla , 53, 54 midbrain , 40, 44, 48, 53–55, 57

Index

979

pons , 53, 54, 56, 57 pontomedullary sulcus , 53, 54 reticular formation , 54–55

cerebellum biological functions , 56 fl occulonodular lobule , 57 made up of , 55 petrosal surface , 53, 55, 59 suboccipital surface , 55–57, 59–60 surfaces of , 57 tentorial surface , 55, 59 tent-shaped midline structure , 57–58 vermis , 56

cerebrum ( see Cerebrum) nervous system ( see Nervous system) neuropathology ( see Neuropathology) posterior fossa , 52, 54

Neurocritical Care Society (NCS) , 27 Neurocysticercosis

clinical manifestations , 489–490 clinical presentations , 490 human infection , 489 symptomatic , 489 treatment , 490–492 in United States , 489

Neurogenic bladder acute and subacute period , 676, 677 arrefl exic/lower motor bladder , 675 monitoring , 675 parasympathetic stimulation , 674 respiratory complication , 674 somatic stimulation , 674–675 spastic/upper motor bladder , 675 ureterovesical junction , 674 urologic complication , 674

Neurogenic bowel Auerbach’s/Meissner’s plexus , 675 bowel program , 675, 676 fl accid/lower motor neuron bowel , 676 prevalence , 676 refl exic/upper motor neuron , 676

Neurogenic stress cardiomyopathy (NSC) , 557 Neurological examination

basal ganglia examination , 528–529 cerebellar examination , 529 cranial nerve

ARAS fi ber , 525 blown pupil , 526 CNS lesion , 525 corneal refl ex , 527 “doll’s eyes” maneuver , 527 Edinger-Westphal nucleus , 526 gag refl ex , 527 Horner’s syndrome , 526 imaging technique , 526 oculomotor function , 526 pupillary response , 525 syphilis , 527 transtentorial herniation syndrome , 526 vestibulo-ocular refl ex , 527

funduscopic examination , 528 GCS , 524–525 hemispatial/hemibody attention , 525 higher cortical function , 525 motor , 528 refl ex examination , 529 sensation , 529

Neuromuscular antagonist acetylcholine , 951 succinylcholine , 950–951

Neuromuscular disorders (NMDs) ICU-acquired weakness

clinical presentation , 790 diagnosis , 790 electrophysiology , 790 genetic testing , 796 imaging , 795 laboratory testing , 794–795 management , 790 neurophysiology , 795–796 respiratory testing , 795 risk factors , 790 signs , 792–794 symptoms , 790–792 tissue testin g , 796

pathophysiology axolemma , 778 axonal degeneration , 778 axoplasmic transport , 778 caliber fi bers , 778 lower motor neurons , 778, 779 poliomyelitis , 779 segmental demyelination , 778 upper motor neuron , 778, 779 Wallerian degeneration , 778

weak patients acute poliomyelitis , 784 acute porphyria , 785 blood gases , 782 botulism , 787 circulation , 782–783 clinical judgment , 782 diphtheria , 788 discharge planning , 788, 789 GBS , 784 history , 779 hypokalemic periodic paralysi s , 788 LEMS , 786–787 lung function testing , 782 myasthenia gravi s , 786 neurotoxic fi sh poisoning , 787–788 physical examination , 779–780 PM/DM , 788 prophylaxis and maintenance , 783 symptomatic care , 783 synthesis , 781–782 testing , 780–781 tetanus , 788 tick paralysis , 787 ventilation and airway protection , 782–783

Neuromyelitis optica (NMO) , 102 Neuropathology

aneurysms berry , 98 circle of Willis , 98 defi nition of , 98 fusiform , 98 infective/mycotic aneurysms , 98 saccular , 98

blood-brain barrier , 92–93 brain tumors

diffuse astrocytomas , 99 glioblastoma , 99–100 gliomas , 99

Index

980

Neuropathology ( cont .) medulloblastoma , 101 meningiomas , 100–101 metastatic tumors , 101 oligodendrogliomas , 100 schwannomas , 101

central nervous system acute purulent (bacterial) meningitis , 102 astrocytes , 92 axoplasmic constituents , 92 brain abscesses , 102 Creutzfelt-Jacob disease (CJD) , 103 cytoplasmic swelling , 90 ependyma and choroid plexus , 92 focal/diffuse hypoxia/ischemia , 90 immunocompromised host , 102–103 microglia , 92 oligodendrocytes , 92 synaptophysin , 90

cerebral edema , 93 cerebral herniation , 93–94 cerebrovascular disease

CADASIL , 98 cerebral amyloid angiopathy (CAA) , 97–98 global hypoxia/ischemia , 97 ischemic infarcts , 97 ischemic strokes , 97 multi-infarct dementia , 97 posterior reversible encephalopathy syndrome

(PRES) , 97 regional ischemic injury , 97 systemic hypertension , 97 venous thrombosis , 97

demyelinating conditions , 101–102 hydrocephalus , 93–94 neurodegenerative disease , 104 toxic metabolic diseases , 103–104 traumatic brain injury (TBI)

amyloid precursor protein , 95 chronic traumatic encephalopathy , 95 closed head injury , 94 contusion/laceration injury , 95 coup contusions , 95 diffuse axonal injury (DAI) , 95 epidural hemorrhage , 95 primary damage , 94 secondary damage , 94 subdural hemorrhage , 95 traumatic intracranial hemorrhage , 95 traumatic spinal cord injury , 96 vascular/meningeal tearing , 96

vascular malformation arteriovenous malformations (AVMs) , 98–99 capillary telangiectases , 99 cavernous angiomas , 99 venous angiomas , 99

Neuroradiological imaging baseline ventricular size , 837 brain tumors , 839–841 cerebral venous thrombosis , 834–835 computed tomography

angiography and perfusion , 829–830 clinical application , 829 intravenous contrast agent , 829

hypoxia and metabolic insuffi ciency , 835–836 intracranial hemorrhage , 837–839

MRI ( see Magnetic resonance imaging [MRI]) oligemia, stroke and dural sinus thrombosis , 834, 835 seizure disorder , 836–837

Neurorehabilitation brain-injured patient care

caregiver , 887 neuropsychological treatment , 888 patient assessment , 887–888

computed tomography , 883 DOC

coma , 879 Klüver-Bucy syndrome , 881 minimally conscious state , 880 Parkinsonian and cerebellar symptoms , 881–882 pathological postures , 881 posttraumatic mutism , 882 posttraumatic psychomotor agitation , 880–881 severe brain injury , 880 vegetative state , 879–880

electroencephalogram , 882 fi beroptic rhinolaryngoscopy , 886 hydrotherapy , 885–886 mismatch negativity and P300 , 883 MRI , 883–884 neuroimaging , 883 occupational therapy , 886 pharmacotherapy , 886–887 positron emission tomography , 884 protocols , 884–885 single photon emission computed tomography , 884 somatosensory evoked potential , 882–883 stroke rehabilitation , 887 swallowing , 886 transcranial Doppler , 884 urological rehabilitation , 886

Neurosyphilis general paresis and tabes dorsalis , 495 incidence , 494 serologic testing

CSF-VDRL test , 496 nontreponemal tests , 496 treponemal tests , 495–496 venereal disease research laboratory , 495–496

stroke , 494–495 syphilitic gummas , 495 syphilitic meningitis , 494 treatment , 497

Neutropenia acute respiratory distress syndrome , 328 bone marrow aplasia , 328 colony-stimulating factors , 328 fungal infections , 328 galactomannan antigen test , 328 immune and drug-related , 328–329 prophylactic antibiotics , 328 white blood cell count in , 327

Nicardipine , 245 NIHSS. See National Institute of Heath

Stroke Scale (NIHSS) Nimodipine , 248 Nonconvulsive status epilepticus (NCSE) , 535, 761

clinical signifi cance and management , 801 seizures , 761

Non-invasive mechanical ventilation (NIV) , 26–28 Noninvasive monitoring modalities

application , 110

Index

981

cerebral blood fl ow cerebral ischemia , 116–117 indicator dilution method , 117 laser Doppler fl owmetry , 122 transcranial Doppler ( see Transcranial

Doppler [TCD]) neurological function

brain death , 111 electroencephalography ( see Electroencephalography [EEG]) evoked electrical activity , 115–116 level of consciousness , 110–111 limitation of , 110 uses , 110

oxygen supply/demand balance cerebral oximetry , 123 jugular venous oximetry , 122–123 oxygen partial pressure , 122 tissue probes , 123–124

Nonsteroidal anti-infl ammatory drugs (NSAIDs) , 949–950 Norepinephrine , 250 Nurse practitioners (NPs) , 5 Nutrition

assessment of screening , 396–397 stress , 397

complication cellular dehydration , 404 fatal metabolic , 404 fat overload syndrome , 404 hypercapnia , 404 hyperglycemia , 404

critical illness, immunonutrition arginine , 395–396 dietary RNA , 396 glutamine , 395

initiating nutritional support , 399–400 malnutrition , 392 monitoring status , 402 neuroICU patient , 402–404 nutrient administration

enteral feeding , 400–401 enteral vs. parenteral , 402 immune function , 402 intestinal barrier function , 400 parenteral , 401

obese patient , 404 requirement

caloric need calculation , 397–398 carbohydrates , 398–399 lipids , 399 micronutrients , 399 polysaccharides , 398–399 protein , 399–400

starvation ( see Starvation)

O Obstetrics and gynecology (OB/GYN) , 21 Oligemia , 834, 835 Opioids , 285, 288, 312 Oral anticoagulation (OAC) therapy , 580 Organ donation

after cardiac death , 914 consent for

decoupling , 905 designated requestors , 904

family characteristics , 904–905 IOM recommendations , 905 OPO , 904

medical management algorithmic approach , 907, 908 central venous pressure (CVP) , 909 donor lung ventilator , 912 excessive fl uid resuscitation , 910 goals , 906–907 hemodynamic and cardiovascular , 905–906 hemodynamic instability, differential

diagnosis of , 909 HRT use , 911 intensivist-led donor management

program , 906 low-dose dobutamine stress tests , 908 PAC , 908 pulmonary artery pressure , 912 pulmonary function , 911–912 respiratory status , 911 transesophageal echocardiography (TEE) , 907 transthoracic echocardiography (TTE) , 907 vasodilatation , 909 vasopressors , 910–911

supportive care , 913–914 Organ dysfunction

cardiovascular altered cerebral autoregulation , 418 cardiac arrest , 417 endocarditis , 417 hypertensive crisis , 418

endocrine , 421 liver

acute liver failure , 419–420 hepatic encephalopathy , 420

metabolic encephalopathy , 421 renal

dialysis disequilibrium syndrome , 421 uremic encephalopathy , 421

respiratory hypoxia and hypercapnia , 418 sepsis associated encephalopathy , 419 sickness behavior syndrome , 418–419

Orthostatic hypotension , 671–672 Oxytocin , 295

P Parasitic infections, CNS

amoebic meningoencephalitis , 489 cerebral malaria

pathogenesis , 487–488 treatment , 488–489

echinococcal disease , 492–493 neurocysticercosis

clinical manifestations , 489–490 clinical presentations , 490 human infection , 489 symptomatic , 489 treatment , 490–492 in United States , 489

strongyloidiasis , 493 toxocariasis , 493–494

Parinaud’s syndrome , 78 Parkinson disease (PD) , 272 Paroxysmal nocturnal hemoglobinuria , 327

Index

982

Patient safety indicators (PSIs) , 11 Pediatric neurocritical care

blood loss , 689 brain death , 690 CBF , 683 CSW , 687 developmental considerations , 682 DI , 687–688 hemodynamic physiology , 682–683 intraoperative anesthetic drugs and agents , 683 perioperative intravenous fl uids

acute hyponatremia , 686 glucose/no glucose , 688–689 normal saline , 684 OW and OS , 684 urine tonicity , 686

postoperative neurocritical care , 683 postoperative renal salt and water handling , 686 postoperative sedation and pain management , 689 seizures and status epilepticus , 689–690 SIADH secretion , 686–687

Pediatric trauma. See Traumatic brain injury (TBI), pediatrics

Pentamidine , 313 Perfusion, neuroradiological imaging , 829–830 Peripheral parenteral nutrition (PPN) , 401 Periventricular demyelination , 101 Pharmacotherapy

brain and central nervous system effect of , 944–945 routes of administration , 945

critical care pharmacist , 959 miscellaneous agent

conivaptan and tolvaptan , 957–958 desmopressin , 957 intravenous immunoglobulin , 958 magnesium , 959 nimodipine , 958–959 statins , 959

neurorehabilitation , 886–887 pharmacokinetics

context-sensitive halftime , 943 distribution , 942 elimination , 942–943 metabolism , 942 route of administration , 942 steady-state level , 943–944

Phenobarbital , 374 Phenytoin , 374, 805 Physician assistants (PAs) , 5 Physician quality reporting initiative (PQRI) , 14 Physician quality reporting system (PQRS) , 14 PICA. See Posterior inferior cerebellar artery (PICA) Pituitary adenoma , 850 Polycythemia vera (PV) , 333 PONV. See Postoperative nausea and vomiting (PONV) Positive end-expiratory pressure (PEEP) , 16 Positive pressure ventilation (PPV) , 13–15 Posterior inferior cerebellar artery (PICA) , 58, 60–61 Posterior reversible encephalopathy syndrome (PRES) ,

267, 381, 533, 695 Postoperative complications

anaphylactic allergy , 866–867 anterior cervical discectomy and fusion , 865 arterial hemorrhage , 875 bifrontal craniotomy , 868

brachial plexus injury , 874 cerebral hyperemia , 871 craniopharyngioma , 872 Dupuytren’s contracture , 866 failed back syndrome , 865–866 fl accid paralysis and apnea , 871 hypoglycemia , 865 hypothermia , 869 intracerebral hemorrhage/ischemia , 868 myocardial infarction , 875 neuromuscular blockade , 870 periorbital edema , 873 PONV , 864 postoperative visual loss , 873–874 pupil , 870–871 respiratory failure , 876 seizure , 867, 869 stroke , 870 subarachnoid hemorrhage , 871–872 tumor excision , 868–869

Postoperative nausea and vomiting (PONV) , 864

Posttransfusion pupura , 330 Post-traumatic seizures (PTS) , 802 Potassium homeostasis

hyperkalemia , 371–372 hypokalemia , 372–373 renal excretion , 371 transcellular shift , 371

Praziquantel , 492 Prehospital care system

central nervous system injury airway , 158 breathing , 158 circulation , 158 disability and destination , 158–159 head injury , 157–158 hyperbaric oxygen , 159 hyperventilation , 159 hypoglycemia , 159 pediatric considerations , 159

EMS , 150–151 hypothermia

application , 156–157 complications of , 155–156 induction , 154–155 maintenance of , 155 rewarming , 155 subarachnoid hemorrhage , 157 targeted temperature management , 154 traumatic brain injury , 157

resuscitation and 2010 AHA guidelines ACLS , 151 adult and pediatric , 151–152 advanced cardiac life support , 152–153 airway management , 152 cardiopulmonary resuscitation , 154 ethical care , 151 neonatal resuscitation , 153–154 pediatric advanced life support , 153

spinal cord injury clinical evalution , 159–160 complicating care , 160 cricoid pressure , 160 negative inspiratory force , 160 neurological evaluation , 162

Index

983

stroke Cincinnati Prehospital Stroke Scale , 161 clinical observation , 161–162 Los Angeles Motor Score , 161, 162 transport of patients , 161 treatment of , 162

PRES. See Posterior reversible encephalopathy syndrome (PRES) Pressure-regulated volume control (PRVC) , 22–23 Pressure support ventilation (PSV) , 20–21 Primitive neuroectodermal tumors (PNETs) , 720 Progressive multifocal leukoencephalopathy (PML) ,

102, 503–505 Progressive supranucelar palsy (PSP) , 275 Prolactin (PRL) , 295 Propofol , 284–285, 287 Propofol infusion syndrome (PRIS) , 283 Propofol-related infusion syndrome (PRIS) , 384 Proportional assist ventilation (PAV) , 25–26 Prosopagnosia , 78 Prothrombin complex concentrates (PCCs) , 580 Pseudothrombocytopenia , 330 Pulmonary embolism (PE)

diagnosis , 349 massive and submassive , 349 treatment , 350

Pulmonary oxygen toxicity (POT) , 44

Q Quality improvement

AANS , 12 complex medical information , 10 evaluation of , 12 future aspects , 16 Institute of Medicine , 10–11 medical errors , 10 in medicine , 14 mortality and length of stay , 13 in neuroICU

communication , 16 DVT prophylaxis , 14–15 handoffs , 16 hospital-acquired complications , 15 national quality initiatives , 15 single institution quality project , 15–16

NQF , 12 PSIs , 11 QIs , 11 stakeholder , 12 UHC , 12

Quality indicators (QIs) , 11

R Radiation therapy , 713–714 Radiographic imaging

artery aneurysm, lateral view , 583, 585 catheter angiography , 583, 584 imaging modality , 583 intraparenchymal hemorrhage , 583 intraventricular hemorrhage , 583, 584 ischemic vs. hemorrhagic stroke , 583 subarachnoid hemorrhage , 583, 584

RBC transfusions (RBCT) , 323 μ-receptor , 285 Recursive partitioning analysis (RPA) , 712

Reduction of cerebral metabolism of O 2 (CMRO 2 ) , 282 Regional wall motion abnormalities (RWMA) , 556 Renal replacement therapy

acute brain injury patient critical aspects of , 386 intermittent vs. CRRT , 386–387

indications for , 385–386 modalities of , 386

Respiratory complication , 671–672 Respiratory pattern

apneustic breathing , 523 ataxic breathing , 524 Biot’s respirations , 524 Cheyne-stokes respirations , 524 Kussmaul respirations , 524 persistent hyperventilation , 523

Respiratory system (RS) physiology defi nition , 4 driving pressure , 4 dysfunction , 12 function of , 67 gas exchange , 11 gravitational and non-gravitational forces , 9 lung compliance , 5 lung volume , 6 minute ventilation (V E ) , 7 ventilation and perfusion relationships , 9–11 ventilation distribution , 8 ventilation perfusion , 9

Response Assessment in Neuro-Oncology (RANO) , 713 Rickettsial disease , 500–501 Rocky Mountain spotted fever rash , 437–438, 500–501

S SCA. See Superior cerebellar artery (SCA) SCI. See Spinal cord injury (SCI) Secondary brain injury (SBI) , 127 Sedation and analgesia (S&A)

acute phase and subacute phase , 289 barbiturates , 287 benzodiazepines , 285–286 delirium , 288–289 DEX , 286–287 ketamine , 286 LOS , 281 monitoring sedation , 288 opioids , 285 pharmacokinetic parameters , 282 principle of

CBF , 283–284 CMRO 2 , 282 ICP , 284 seizures , 284

propofol , 284–285 side effects of

benzodiazepine , 287–288 dexmedetomidine , 288 opioids , 288 propofol , 287

Seizures , 446, 749–750 AEDs

benzodiazepines , 809 epilepsy surgery , 810–811 phenytoin and fosphenytoin , 809 status epilepticus , 810

Index

984

Seizures ( cont .) causes , 803–804 clinical fi ndings , 802 EEG

epileptiform , 801 indications , 800 NCSE , 800, 801

intoxication nonrecreational drug-induced seizures , 807–808 recreational drug-induced seizures , 808

malignancy , 803 metabolic disorders

glucose metabolism , 806 hepatic encephalopathy , 807 hypocalcemia , 806 hypomagnesemia , 806 hyponatremia , 805–806 hypoparathyroidism , 806 hypophosphatemia , 806 uremia , 806–807

PTS , 802 transplantation

bone marrow , 804–805 liver , 804 lung , 804

and vascular lesions stroke , 803 subarachnoid hemorrhage , 802–803 vasculitis , 803

Selegiline , 275 Sensation

dermatome , 75, 79 pain and temperature , 73, 77, 78 peripheral nerves , 75, 80 touch and proprioception , 73, 75

Sepsis associated encephalopathy , 419 Sickle cell disease (SCD)

cerebral ischemia , 324 clinical features , 324 complications of , 325 treatment of , 324–325

Sickness behavior syndrome , 418–419 Society of critical care medicine (SCCM) , 20, 286 Sodium plasma concentration

determinant of , 356 disorders of , 356 serum osmolality , 357 total body water (TBW) , 356

Somatosensory evoked potentials (SSEPs) , 116, 766, 882–883

Somatostatin (SS) , 295 Spasticity , 676, 677 Spastic/upper motor bladder , 675 Spetzler-Martin grading system , 585 Spinal cord injury (SCI) , 251, 750

autonomic dysrefl exia , 269 bradydysrhythmias , 269 cardiac sympathetic chain , 268 causes of death , 268 classifi cation of , 668–669 craniocervical junction

atlanto-occipital dislocation , 624, 625 cock robin head appearance , 625 Down’s syndrome , 625 Grisel’s syndrome , 625 Jefferson fracture , 624, 626

odontoid fractures , 625, 626 rheumatoid arthritis , 625 traumatic fracture , 625–626

epidemiology , 619–620 imaging

CT and MRI , 623–624 radiographic assessment , 623

management and evaluation aggressive volume resuscitation , 620–621 ATLS protocol , 620 emergent intubation , 620 forced vital capacity , 620 Glasgow Coma Scale score , 620 Swan-Ganz catheter monitoring , 620–621 vasopressor , 620–621

medical management of diaphragm stimulator placement , 630 DVT prophylaxis , 632–633 genitourinary complication , 633 multisystem implications , 629 norepinephrine , 631 organism identifi cation , 630 phenylephrine , 631 respiratory complications , 629, 630 tracheostomy , 630 venous thromboembolic disease , 632 ventilator weaning strategy , 630

neurologic examination anterior cord syndrome , 622 ASIA grade , 621, 622 Brown-Sequard cord syndrome , 622 central cord syndrome , 621–622 “log-rolling” patient , 621 motor score , 621 posterior cord syndrome , 622 sensory score , 621

outcomes , 669–670 patient recovery , 673 patient rehabilitation

autonomic dysrefl exia , 673–674 bladder ( see Neurogenic bladder) bowel ( see Neurogenic bowel) contraction and edema , 670–671 heterotopic ossifi cation , 677–678 orthostatic hypotension , 671–672 pain , 676–677 pressure ulcers , 672–673 psychological adjustment , 678 respiratory complication , 671–672 spasticity , 676, 677

pharmacologic agents, role , 633–635 sensorimotor defi cit , 268 subaxial cervical spine injury

compression fractures , 626 fl exion teardrop fractures , 626, 627 inferior articulating process , 626, 627 perched, jumped/locked facets , 627, 628

surgical treatment of neurologic deterioration/optimizing

potential , 635 prospective pilot study , 635 spinal column injury treatment , 636–637 surgical decompression , 636 traumatic spinal cord compression , 635

survival rate and prevalence , 668 tachydysrhythmias , 268

Index

985

thoracolumbar injury burst fractures , 628, 630–631 chance fractures , 628 compression fractures , 628 Denis system , 627 fracture-dislocation types , 628, 632 gunshot wound , 628

Spinal deformity advantage of , 662–663 aggressive technique , 662, 663 closing wedge osteotomy , 662 complication , 663–664 consciousness , 659 defi nition , 659 fi rst line therapy , 661 fl at-back syndrome , 661 polysegmental osteotomy , 662 progressive muscle fatigue , 659 pseudarthrosis , 661 salvage spine surgical technique , 661 Smith–Petersen osteotomy technique , 662 surgical modality , 661 thoraco-lumbar/lumbar curve , 661

Spinal epidural abscess clinical features and diagnostic

considerations , 462 incidence , 461 microbiology of , 462 pathophysiology , 461–462 risk factors , 462 treatment , 462–463

Spinal infection anterior approach , 654, 657 posterior approach , 652, 654 single stage , 654–656, 658 two stage , 658

Spinal instrumentation anterior

cervical instrumentation , 648 intervertebral cages , 648–649 thoracic instrumentation , 648

optimal biomechanical force , 647 posterior

Harrington distraction rod , 647 hook rod system , 647 Luque instrumentation , 647 pedicle screw , 647–648

sacro-pelvic instrumentation , 649 Spinal neoplasm

acute deterioration , 658 Harrington classifi cation , 658 indications , 658 local lesions , 658 multi-modal treatment , 658 patient outcomes , 658 prognosis , 659 rostral-caudal effect , 659 spill tumor , 659 spinal instability/neurologic impairment , 658 spondylectomy/vertebrectomy , 659, 660 structural integrity , 658, 659

Spinal shock syndrome , 528 Spinal trauma

atlanto-axial fracture interposed odontoid process , 650 transarticular screw fi xation , 650

ventral technique , 650–651 wiring/graft-wiring technique , 650

subaxial cervical facet dislocation , 651 thoracic and lumbar fracture

biomechanical characteristics , 651 bony/ligamentous structures , 651 Denis classifi cation , 651 fl exion-distraction injury , 651 hook rod construct , 652 indication , 651 pedicle screw rod , 652, 653 primary load bearing , 651

Spinal tuberculosis , 472–473 Spine surgery , 856–857 Spontaneous breathing tests (SBT) , 40–41 Starvation

immune effects and infection rates , 393–394 metabolic response

catecholamine levels , 392 peripheral conversion , 392

organ function hypermetabolism-multiple organ failure

(HOF) , 393 mortality rates , 393 multiple system organ failure (MSOF) , 393

stress effects , 397 wound healing , 394–395

Status epilepticus (SE) , 270 Stroke , 301

AF , 265 beta-blockers , 267 cardiac monitoring , 267 CK-MB , 263 feline model , 264 intraoperative neuroanesthesia , 855–856 murine model , 264 myocardial infarct , 265 neuroradiological imaging , 834, 835 neurorehabilitation , 887 patients recurrence , 265 prehospital care system

Cincinnati Prehospital Stroke Scale , 161 clinical observation , 161–162 Los Angeles Motor Score , 161, 162 transport of patients , 161 treatment of , 162

Strongyloidiasis , 493 Study of treatment of acute hypertension (STAT) , 242 Subacute sclerosing panencephalitis (SSPE) , 503 Subarachnoid hemorrhage (SAH) , 301, 323, 533, 839

catecholamine hypothesis , 263 CBN , 263 genetic polymorphisms , 262 hypertensive normovolemic therapy , 249 poor grade , 248 prehospital care system , 157 rebleeding prevention , 247–248 systolic dysfunction and function , 262

Subdural hematoma , 831 Sudden unexpected death in epilepsy

(SUDEP) , 272 Superfi cial VTE , 351 Superior cerebellar artery (SCA) , 56–58, 62 Sustained low-effi ciency dialysis (SLED) , 386 Synchronized Intermittent Mandatory Ventilation

(SIMV) , 19

Index

986

Syndrome of inappropriate antidiuretic hormone (SIADH) , 363, 581, 686–687, 808

Synucleinopathies amantadine , 275 dopamine , 275 LBD , 273 L-dopa treatment , 274 MSA , 274 parkinson disease

cell loss , 273 vs. orthostatic hypotension , 274 in vivo , 273

selegiline , 275 Syphilis

categories , 494 neurosyphilis

general paresis and tabes dorsalis , 495 incidence , 494 serologic testing , 495–496 stroke , 494–495 syphilitic gummas , 495 syphilitic meningitis , 494 treatment , 497

pathogenesis , 494 Systemic infl ammatory response syndrome

(SIRS) , 47, 395 Systolic blood pressure (SBP) , 547

T Targeted temperature management (TTM) , 743

bladder temperature , 763 blood gas interpretation and hypothermia , 765 cold intravenous fl uids , 763 complications of , 764–765 endovascular cooling devices , 763–764 hypothermia treatment, duration of , 763 initiate hypothermia, timing of , 762–763 post-cardiac arrest care , 762 surface cooling devices , 764 therapeutic window , 762

TBI. See Traumatic brain injury (TBI) TCD. See Transcranial Doppler (TCD) Theophylline , 374 Therapeutic hypothermia (TH)

acute liver failure , 750 aneurysmal subarachnoid hemorrhage , 749 cardiac arrest , 744 cerebral ischemia , 744 ICH

peri-hematomal edema , 748 risk factor , 749

ischemia and stroke hemicraniectomy , 748 pharmacological and physical strategies , 748 post-ischemic edema , 747 rewarming vs. normothermia treatment , 747

methods and devices , 746 neuroprotective effect , 745 primary neuronal injury , 744 rewarming , 751–752 risks and side effects , 750–751 secondary neuronal injury , 744 seizures , 749–750 spinal cord injury , 750 TBI , 746 TTM , 743

Thermal diffusion fl owmetry , 139 Thrombocytopenia

incidence , 329 management

bleeding risk and platelet transfusions , 332 GPIIb/GPIIIa inhibitor-induced , 330 heparin-induced thrombocytopenia (HIT) , 331 passive alloimmune , 330 posttransfusion pupura , 330 pseudothrombocytopenia , 330 thrombotic thrombocytopenic purpura (TTP) , 330–331

mechanisms and causes , 329 moderate , 330 platelet counts , 329–330 severe , 330

Thrombolysis blood pressure management , 700–701 intra-arterial thrombolysis , 701–702 intravenous thrombolysis , 698–700 mechanical thrombectomy

IV t-PA , 702–703 MERCI devices , 702

oral anticoagulation , 701 transcranial ultrasound , 702

Thrombosis alteplase , 956 aspirin/dipyridamole , 957 heparin , 956 LMWHs and fondaparinux , 957

Thrombotic microangiopathy (TMA) , 326–327 Thrombotic thrombocytopenic purpura (TTP) , 330–331 Thromboytoses , 333–334 Thyroid releasing hormone (TRH) , 295 Thyroid stimulating hormone (TSH) , 295 Tinel’s sign , 87 Tinzaparin , 347 Tissue factor (TF) , 344 Tonsillar herniation , 832–833 Total parenteral nutrition (TPN) , 401 Toxocariasis , 493–494 Transcranial Doppler (TCD) , 533, 537, 683, 697, 767

cerebral vasospasm , 551–552 clinical application

brain death , 118–119, 121 traumatic brain injury , 118 vasospasm , 118, 120

determination of , 117 pediatrics , 606 shape of waveform , 118, 119 ultrasound waves , 117–118

Transfusion-related acute lung injury (TRALI) , 323 Transient left ventricular apical ballooning (TLVAB) , 260 Transphenoidal hypophysectomy , 850–851 Transtentorial herniation , 831–832 Transtentorial herniation syndrome , 526 Traumatic brain injury (TBI) , 746

amyloid precursor protein , 95 cerebral lesion , 267 chronic traumatic encephalopathy , 95 closed head injury , 94 coagulopathy , 337 contusion/laceration injury , 95 coup contusions , 95 diagnosis , 592–593 diencephalic seizure , 267 diffuse axonal injury (DAI) , 95 dysautonomia , 267

Index

987

ECG abnormality , 267 epidemiology

CDC defi nition , 591 deaths , 591 emergency department visits , 591 hospitalizations , 591–592 motor vehicle occupants , 592 pedestrians and cyclists , 592

epidural hemorrhage , 95 excitatory to inbitory ratio model , 268 ICP , 267 monitoring and therapy, CPP

lund concept , 250 norepinephrine , 250

pathophysiology , 592 pediatrics

adrenal insuffi ciency , 614 barbiturate coma , 613 biomarkers role , 608 brain oxygen tension , 611 cardiac arrhythmias , 613 cerebrospinal fl uid drainage , 612 coagulopathy , 614 CPP , 611 CT ( see computed tomography (CT)) decompressive craniectomy , 612–613 epidemiology , 602–603 evaluation , 603 glycemic control , 613–614 grading scales , 603–604 hyperosmolar therapy , 612 induced hypothermia , 612 intracranial hypertension , 610–611 management algorithm , 608–609 MRI , 606 neuromonitoring , 608–610 nutrition , 614 outcome , 614–315 pathogenesis , 603 pilot study , 614 seizure prophylaxis , 613 transcranial Doppler ultrasonography , 606 venous thromboembolism prophylaxis , 614

physiological parameters blood pressure , 594 brain oxygen (PbtO 2 ) , 593, 594, 597 CPP/autoregulation , 593, 594 intracranial pressure , 595 ( see also Intracranial pressure) microdyalisis , 597–598 seizure prophylaxis , 598 systemic oxygenation , 594 temperature management , 594

prehospital care system , 157 primary damage , 94 secondary damage , 94 spinal cord injury (SCI) , 251 STAT , 250 subdural hemorrhage , 95 transcranial Doppler , 118 traumatic intracranial hemorrhage , 95 traumatic spinal cord injury , 96 vascular/meningeal tearing , 96

Traumatic Coma Databank (TCDB) , 733 Tuberculoma , 471–472 Tuberculous meningitis

clinical presentation , 468–469 diagnosis , 469–470

vs. HIV infection , 467–468 pathogenesis , 468 prognosis and sequelae , 471 treatment , 470–471

U Uncal herniation , 832 Unfractionated heparin (UFH) , 345 United council of neurological subspecialties (UCNS) , 4, 24 University health system consortium (UHC) , 12 Upper extremity thrombosis , 351 Uremic encephalopathy , 30, 421

V VA. See Vertebral artery (VA) VAE. See Venous air embolism (VAE) Vagal syncope , 276 Vascular malformation

arteriovenous malformations (AVMs) , 98–99 capillary telangiectases , 99 cavernous angiomas , 99 venous angiomas , 99

Vascular neurosurgery arteriovenous malformations , 852, 854 carotid endarterectomy , 854 cerebral aneurysms , 851–852 endovascular , 854–855

Vasospasm prophylaxis calcium channel blockers , 553 endovascular interventions , 554–555 ERA , 553–554 magnesium sulfate , 553 medical treatment , 554 statins , 553 triple-H therapy , 552–553

Venous air embolism (VAE) , 849 Venous thromboembolism (VTE) , 343

clinical consequences , 343 deep vein thrombosis

compression ultrasonography (CUS) , 349 treatment , 349–351

diagnosis , 349 mechanical prophylaxis

graduated compression stockings , 345–346 inferior vena cava fi lters , 346 intermittent pneumatic compression device , 346

pathogenesis , 344–345 pharmacologic prophylaxis

bleeding risks , 347 combination vs. mechanical prophylaxis , 346 dalteparin , 347 heparin administration timing , 347 LMWH vs. UFH , 347 low-dose UFH and LMWH , 347 tinzaparin , 347

pulmonary embolism , 349–350 risk assessment , 345 treatment

alteplase , 350 catheter-based interventions , 350 IVC fi lters , 350 surgical embolectomy , 350 therapeutic anticoagulation , 350

Ventilation-perfusion (V/Q) scintigraphy , 349 Ventilator-associated pneumonia (VAP) , 47–48

Index

988

Ventilator-induced diaphragmatic dysfunction (VIDD) , 48–49

Ventilator-induced lung injury (VILI) atelectrauma , 43–44 barotrauma , 44–45 lung protective strategies , 45–46 POT , 44 volutrauma , 43

Ventriculostomy , 130 Vermian lesions , 72 Vertebral artery (VA) , 55, 57, 58, 60, 694 Vertebral osteomyelitis

clinical presentation and diagnostic considerations , 464–466 incidence , 463 microbiology of , 464 pathogenesis , 464 risk factors , 463–464 treatment , 466

Vestibular schwannoma , 722 Video laryngoscopy

Airtraq ® , 184, 185 blades shapes , 184 Clarus ® Levitan optical airway scope , 184, 186 vs. conventional laryngoscopy , 185 device cost , 184 ETT exchange , 186 GlideScope ® , 184, 185 glottic view , 186, 187 Storz C-MAC ® , 184, 185

Viral meningitis and encephalitis clinical manifestations , 450–451

aseptic meningitis , 451 CSF pleocytosis , 451 LCMV meningitis , 451

epidemiology arboviruses , 447 Coxsackie virus , 447 enteroviruses , 447 rabies , 448 West Nile virus (WNV) , 448

laboratory diagnosis , 452–453 nonviral causes of , 454 pathogenesis

CSF antibody testing , 448 enterovirus serotype , 451 herpes encephalitis , 449–450, 454–455 macacine herpesvirus 1 , 456 PCR testing , 451

primary HIV infection , 448 rabies , 455–456 rabies infection , 450 West Nile viral thalamic encephalitis , 455

treatment , 456 Visual agnosias , 78 Visual evoked potentials (VEPs) , 115 Visual loss , 848–849 Volutrauma , 43 von Willebrand factor (vWF) , 344

W Waddling gait , 72 Wallenberg’s syndrome , 78 Wall motion abnormalities (WMA) , 556 Water and electrolyte management

calcium disorders , 373 hypercalcemia , 374 hypocalcemia , 374

hypernatremia ( see Hypernatremia) hyponatremia ( see Hyponatremia) magnesium disorders , 374

hypermagnesemia , 375 hypomagnesemia , 375–376

phosphorus disorders , 373–374 hyperphosphatemia , 374–375 hypophosphatemia , 375

plasma osmolality regulation , 357–358 potassium homeostasis ( see Potassium homeostasis) sodium homeostasis , 358–359 sodium plasma concentration , 356–357

Weber’s syndrome , 78 Wernicke’s aphasia , 66 Wernicke’s encephalopathy , 421 Whipple’s disease , 502–503 World Federation of Neurological Surgeons

(WFNS) , 546, 851

X Xanthochromia , 438

Z

Zygomycosis , 480–481

Index