Podcasts about neurocritical

In this week's podcast, Neurology Today's editor-in-chief highlights articles on proposed updated criteria for diagnosing MS before symptoms manifest, the use of large language models to address administrative burden with electronic medical records, and the growth of training programs in neonatal neurocritical care.

Disturbances in neurological function due to primary neurological disorders or organ failure from critical illness are common in patients admitted to the ICU. In this episode, Dr. Zanotti discusses the neurological physical exam in the ICU. He is joined by Dr. Adam Rizvi, a neurologist with Neurocritical care and vascular neurology fellowship training who currently practices critical care, neurocritical care, and tele-neurology/tele-stroke in several hospitals in California. In addition to his clinical work, Dr. Rizvi is an accomplished educator and researcher. Additional Resources: Neurological examination of critically ill patients: a pragmatic approach: Report of an ESICM expert panel. Intensive Care Med 2014. https://pubmed.ncbi.nlm.nih.gov/24522878/ Critical Matters Podcast episode: Brain Death / Death by Neurological Criteria. Host: S. Zanotti. Guest: D. Greer: https://soundphysicians.com/podcast-episode/?podcast_id=342&track_id=1677810255 Clinical Neuroanatomy Made Ridiculously Simple. Edition 6. Stephan Goldberg, MD: https://amzn.to/4cC34uZ Books mention in the episode: Meditations. By Marcus Aurelius. Translation by Gregory Hayes: https://amzn.to/4eBxK1d

In recent years, we have seen healthcare systems collapse under the strain of natural disasters and armed conflict and hundreds of millions of people being forcibly displaced. So, how do we meet the healthcare needs of people in humanitarian disasters, let alone those living through these nightmares with a rare disease such as NMO?To talk about the unique challenges of diagnosing and treating rare conditions like NMO in these low-resource settings, we are joined by Dr. Farrah Matten.She highlights common barriers such as lack of disease awareness, limited diagnostic testing availability, and restricted treatment access. Dr. Mateen also proposes concrete goals to better support patients facing the most challenging circumstances.ABOUT US:The Demystifying NMO and MOG podcast is a Sumaira Foundation (TSF) project andwas made possible with the generous support of Genentech.SOCIAL & WEBSITE:Farrah Mateen, MD, PhDWebsite - https://doctors.massgeneralbrigham.org/provider/Farrah+J+Mateen/255866Global Neurology Research Group - www.massgeneral.org/neurology/research/global-neurology-research-groupTwitter - https://twitter.com/FarrahMateenThe Sumaira FoundationWebsite - www.sumairafoundation.orgFacebook - www.facebook.com/TheSumairaFoundationLINKS:Mateen FJ. Neurological disorders in complex humanitarian emergencies and natural disasters. Ann Neurol. 2010 Sep;68(3):282-94. doi: 10.1002/ana.22135. PMID: 20818788.Mateen FJ. Neurocritical care in developing countries. Neurocrit Care. 2011 Dec;15(3):593-8. doi: 10.1007/s12028-011-9623-7. PMID: 21863357.Mateen FJ, Hanafi I, Birbeck GL, Saadi A, Schmutzhard E, Wilmshurst JM, Silsbee H, Jones LK Jr; AAN Quality Committee. Neurologic Care of Forcibly Displaced Persons: Emerging Issues in Neurology. Neurology. 2023 May 16;100(20):962-969. doi: 10.1212/WNL.0000000000206857. Epub 2023 Mar 1. PMID: 36859408; PMCID: PMC10186241.Mateen FJ. Rectifying global inequities in neuromyelitis optica diagnosis and treatment. Mult Scler. 2023 Jul;29(8):932-935. doi: 10.1177/13524585231179108. Epub 2023 Jun 10. PMID: 37300419.SUPPORT the PodcastDonate to Illuminatehttps://www.sumairafoundation.org/advocacy/donate/CREDITS:Producer & Host - Brian DawsonMusic - Denys Kyshchuk from Pixabay

In this episode, we discuss the management of seizures in the intensive care unit. Our guest is Dr. Brandon Foreman – an internist and neurologist with fellowship training in epilepsy and Neurocritical care. Dr. Foreman is an Associate Professor of Neurology at the University of Cincinnati Medical College. He is the Associate Director for Neurocritical Care Research. An excellent clinician, researcher, and educator focusing on Clinical Neurophysiology and Neurocritical care. Additional Resources: Seizure Management in the Intensive Care Unit. Boggs JG. Curr Treat Options Neurol 2021: https://pubmed.ncbi.nlm.nih.gov/34697528/ American Epilepsy Society – Website with multiple clinical Guideline: https://pubmed.ncbi.nlm.nih.gov/34697528/ Treating Rhythmic and Periodic EEG Patterns in Comatose Survivors of Cardiac Arrest. Ruijter BJ, et al. N Engl J Med 2022: https://pubmed.ncbi.nlm.nih.gov/35196426/ Books mentioned in this episode:  Siddhartha: A Novel. By Hermann Hesse: https://www.amazon.com/Siddhartha-Novel-Hermann-Hesse Netflix- Reference Guide on Our Freedom and Responsibility Culture https://igormroz.com/documents/netflix_culture.pdf

Dr. Neha Dangayach talks Drs. Susanne Muehlschlegel and Adeline Goss about characterizing the prognostic language clinicians use in critical neurologic illness. Read the related article in Neurology. Visit NPUb.org/Podcast for associated article links.

In this episode of the Neurophilia Podcast we sat down with Neuro-Twitter star, Dr. Casey Albin to discuss her "drunken stagger" to neurology, the nuts and bolts of neurocritical care training, and the unique challenges of being a neurointensivist. We also spent some time talking about digital scholarship and the future of online Neurology communities in a "post-Musk" era. Dr. Albin shares what she loves most about her job as a neurocritical care doctor, important pearls regarding neuroprognostication, and unique ways to promote health and wellness in shift-work. Casey Albin, MD is an Assistant Professor at Emory University School of Medicine where she is a member of the Department of Neurocritical Care. Her research interests focus on educational innovations in acute neurologic emergencies and Neurocritical care. She serves on the Editorial Boards of several journals and is passionate about open-access neurologic education through Twitter, blogs, and podcasts. Follow the Neurophilia Podcast on Twitter and Instagram @NeurophiliaPodFollow Dr. Casey Albin on Twitter @caseyalbinFollow Dr. Nupur Goel on Twitter @mdgoelsFollow Dr. Blake Buletko on Twitter @blakebuletkoSupport the show

You may have noticed that the last couple of podcasts we've published were neuro-related talks that were recorded at the BRAIN Symposium which took place earlier this year. If you want more neurocritical care podcasts make sure to head over to the NeuroResus channel. Over the coming months we'll be publishing more talks from the BRAIN Symposium around neurocritical care,  neuro resuscitation, and neuro emergencies. Subscribe to Neuroresus in your preferred podcast app, or sign up to the Neuroresus newsletter to receive updates directly in your inbox.

This month, tune into the all new Perspectives Series: Dr. Allan Ropper, Professor of Neurology at Harvard Medical School where he formally serves at the Executive Vice Chair of Neurology and Raymond D. Adams Master Clinician. NCS offers free CE credits for the NCS Podcast Series episodes. Listen to any of the posted episodes, complete a five-question survey, and claim your credits here! Credits are available for physicians, pharmacists, nurses, and non-physicians. The NCS Podcast is the official podcast of the Neurocritical Care Society. 

This month, tune into the all new Perspectives Series: Dr. Tom Bleck, Professor of Neurology at Northwestern Feinberg School of Medicine and founding president of the Neurocritical Care Society. NCS offers free CE credits for the NCS Podcast Series episodes. Listen to any of the posted episodes, complete a five-question survey, and claim your credits here! Credits are available for physicians, pharmacists, nurses, and non-physicians. The NCS Podcast is the official podcast of the Neurocritical Care Society. 

In this World Shared Practice Forum podcast, Dr. Akash Deep, Director of the Pediatric Intensive Care Unit, Staff Governor, and Professor in Pediatric Critical Care at King's College Hospital, discusses his recent publication on non-transplant options in pediatric acute liver failure. He describes important considerations for the management of acute liver failure and commonly associated toxicities, and offers insights into the paradigm shift currently evolving in the field and what we can expect in the trends of future treatment pathways. Upon listening to this presentation, learners should be able to: - Apply strategies for management of acutely ill children with acute liver failure - Describe various forms of toxicity commonly associated with acute liver failure Publication date: June 28, 2022. Articles Referenced: • Deep A, Nagakawa S, Tissieres P. Non-transplant options in paediatric acute liver failure-what is new?. Intensive Care Med. 2022;48(1):114-117. (00:49) • Habib M, Roberts LN, Patel RK, Wendon J, Bernal W, Arya R. Evidence of rebalanced coagulation in acute liver injury and acute liver failure as measured by thrombin generation. Liver Int. 2014;34(5):672-678. (7:03) • Slack AJ, Auzinger G, Willars C, et al. Ammonia clearance with haemofiltration in adults with liver disease. Liver Int. 2014;34(1):42-48. (13:27) • Hunt A, Tasker RC, Deep A. Neurocritical care monitoring of encephalopathic children with acute liver failure: A systematic review. Pediatr Transplant. 2019;23(7):e13556. (17:39) • Kochanek PM, Adelson PD, Rosario BL, et al. Comparison of Intracranial Pressure Measurements Before and After Hypertonic Saline or Mannitol Treatment in Children With Severe Traumatic Brain Injury. JAMA Netw Open. 2022;5(3):e220891. (19:51) Citation: Deep A, Daniel D, Burns JP. Non-transplant Options in Pediatric Acute Liver Failure. 6/2022. Online Podcast. OPENPediatrics. https://youtu.be/iSvZ26drzy0. Please visit: www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open access-and thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu Please note: OPENPediatrics does not support nor control any related videos in the sidebar, these are placed by Youtube. We apologize for any inconvenience this may cause.

In Episode 25 of Dr. Dave On Call, we discuss the neurological effects of COVID-19 with Neurocritical care specialist, Dr. Eric Liotta of Northwestern Medicine. Many individuals who have experienced COVID-19 have encountered neurological symptoms. For example, loss of taste and smell have been pathognomonic for the disease. However, many patients have experienced other neurological symptoms such as stroke, malaise, numbness, "brain fog", weakness, etc. We have received much feedback from our listeners regarding their neurological symptoms and thought it would be best to discuss these symptoms with a Neurological specialist, Dr. Eric Liotta. Dr. Liotta is Assistant Professor of Neurocritical Care and Surgery at Northwestern Medicine, Feinberg School of Medicine. He has been on the front lines of the COVID-19 pandemic, treating severely ill patients in the Neurocritical ICU. Further, he has had the opportunity to follow both severely and mildly ill patients in his clinic throughout the pandemic and has valuable insight into the neurological sequelae of COVID-19. We are honored to speak with him. More questions, please visit us: https://drdaveoncall.com/wp/ (https://drdaveoncall.com) Email us: hello@drdaveoncall.com Tweet us: https://twitter.com/drdaveoncall (https://twitter.com/drdaveoncall)

Targets for treatment of raised intracranial pressure or decreased cerebral perfusion pressure in pediatric neurocritical care are not well defined.

Targets for treatment of raised intracranial pressure or decreased cerebral perfusion pressure in pediatric neurocritical care are not well defined.

The field of neurocritical care and traumatic brain injury management is rapidly evolving. We are shifting from older (but not entirely outdated) monitoring techniques to novel diagnostic and therapeutic advances in critical care medicine. Managing intracranial pressure crises involves the careful tiptoeing of a line between maintaining brain circulation and yet reducing intracranial fluid volume. And many of our interventions rely on one simple mathematical construct: CPP = MAP - ICP [Cerebral perfusion pressure = Mean arterial pressure – Intracranial pressure] The importance of this formula cannot be understated. So we are spending 35 minutes today reviewing it, and discussing pearls and pitfalls of ICP monitoring and management. But believe me, it’s worth it. Produced by James E. Siegler and Jon Rosenberg. Music courtesy of Unheard Music Concepts, Rafael Archangel, Milton Arias, and Quincas Moreira. The opening theme was composed by Jimothy Dalton. Sound effects by Mike Koenig and Daniel Simion. Unless otherwise mentioned in the podcast, no competing financial interests exist in the content of this episode. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast. REFERENCES  Rosner MJ and Coley IB. Cerebral perfusion pressure, intracranial pressure, and head elevation. Journal of neurosurgery. 1986;65:636-41. Chesnut RM, Temkin N, Carney N, Dikmen S, Rondina C, Videtta W, Petroni G, Lujan S, Pridgeon J, Barber J, Machamer J, Chaddock K, Celix JM, Cherner M, Hendrix T and Global Neurotrauma Research G. A trial of intracranial-pressure monitoring in traumatic brain injury. The New England journal of medicine. 2012;367:2471-81. Kristiansson H, Nissborg E, Bartek J, Jr., Andresen M, Reinstrup P and Romner B. Measuring elevated intracranial pressure through noninvasive methods: a review of the literature. J Neurosurg Anesthesiol. 2013;25:372-85. Armstead WM. Cerebral Blood Flow Autoregulation and Dysautoregulation. Anesthesiol Clin. 2016;34:465-77. Oddo M, Crippa IA, Mehta S, Menon D, Payen JF, Taccone FS and Citerio G. Optimizing sedation in patients with acute brain injury. Crit Care. 2016;20:128. Carney N, Totten AM, O'Reilly C, Ullman JS, Hawryluk GW, Bell MJ, Bratton SL, Chesnut R, Harris OA, Kissoon N, Rubiano AM, Shutter L, Tasker RC, Vavilala MS, Wilberger J, Wright DW and Ghajar J. Guidelines for the Management of Severe Traumatic Brain Injury, Fourth Edition. Neurosurgery. 2017;80:6-15. Okonkwo DO, Shutter LA, Moore C, Temkin NR, Puccio AM, Madden CJ, Andaluz N, Chesnut RM, Bullock MR, Grant GA, McGregor J, Weaver M, Jallo J, LeRoux PD, Moberg D, Barber J, Lazaridis C and Diaz-Arrastia RR. Brain Oxygen Optimization in Severe Traumatic Brain Injury Phase-II: A Phase II Randomized Trial. Critical care medicine. 2017;45:1907-1914. Harary M, Dolmans RGF and Gormley WB. Intracranial Pressure Monitoring-Review and Avenues for Development. Sensors (Basel). 2018;18. Koenig MA. Cerebral Edema and Elevated Intracranial Pressure. Continuum (Minneap Minn). 2018;24:1588-1602. Jahns FP, Miroz JP, Messerer M, Daniel RT, Taccone FS, Eckert P and Oddo M. Quantitative pupillometry for the monitoring of intracranial hypertension in patients with severe traumatic brain injury. Crit Care. 2019;23:155. Cook AM, Morgan Jones G, Hawryluk GWJ, Mailloux P, McLaughlin D, Papangelou A, Samuel S, Tokumaru S, Venkatasubramanian C, Zacko C, Zimmermann LL, Hirsch K and Shutter L. Guidelines for the Acute Treatment of Cerebral Edema in Neurocritical Care Patients. Neurocritical care. 2020;32:647-666. Robba C, Pozzebon S, Moro B, Vincent JL, Creteur J and Taccone FS. Multimodal non-invasive assessment of intracranial hypertension: an observational study. Crit Care. 2020;24:379.

Current guidelines for management of carotid stenosis are based on a series of trials dating back to the 1990s. If you ask today’s guests, virtually no other area of neurology is so badly in need of an update. Dr. Seemant Chaturvedi, the Stewart Greenebaum Endowed Professor of Stroke Neurology at University of Maryland School of Medicine, and Dr. Cheryl Bushnell is Professor of Neurology, Vice Chair of Research, Stroke Division Chief at Wake Forest Baptist Health join us for a discussion of the major advances in medical therapy for stroke prevention and why these advances require new trials to refine patient selection for revascularization. They’ll also discuss the growing role of plaque imaging in treatment decisions. Series 2, Episode 6

I shouldn’t have to tell you that traumatic brain injury is a major cause of morbidity and mortality. I shouldn’t have to. But I will. And it is. In severe cases of head injury, there can be delayed and irreversible deterioration in the nervous system for which there is no treatment and the prognosis is grim. This week on the program, Dr. Monisha Kumar (University of Pennsylvania) discusses the worst of the worst of these scenarios, what to look out for, and expert recommendations on what to do when it happens. Produced by James E. Siegler and Monisha Kumar. Music courtesy of Rui, Swelling, Unheard Music Concepts, Jahzzar, Ian Southerland, and TRG Banks. The opening theme was composed by Jimothy Dalton. Sound effects by Mike Koenig and Daniel Simion. Unless otherwise mentioned in the podcast, no competing financial interests exist in the content of this episode. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast. REFERENCES Strich SJ. Diffuse degeneration of the cerebral white matter in severe dementia following head injury. Journal of neurology, neurosurgery, and psychiatry. 1956;19:163-85. Adams JH, Graham DI, Murray LS and Scott G. Diffuse axonal injury due to nonmissile head injury in humans: an analysis of 45 cases. Annals of neurology. 1982;12:557-63. Povlishock JT, Becker DP, Cheng CL and Vaughan GW. Axonal change in minor head injury. J Neuropathol Exp Neurol. 1983;42:225-42. Gentry LR. Imaging of closed head injury. Radiology. 1994;191:1-17. Meythaler JM, Peduzzi JD, Eleftheriou E and Novack TA. Current concepts: diffuse axonal injury-associated traumatic brain injury. Arch Phys Med Rehabil. 2001;82:1461-71. Arfanakis K, Haughton VM, Carew JD, Rogers BP, Dempsey RJ and Meyerand ME. Diffusion tensor MR imaging in diffuse axonal injury. AJNR American journal of neuroradiology. 2002;23:794-802. Scheid R, Preul C, Gruber O, Wiggins C and von Cramon DY. Diffuse axonal injury associated with chronic traumatic brain injury: evidence from T2*-weighted gradient-echo imaging at 3 T. AJNR American journal of neuroradiology. 2003;24:1049-56. DeKosky ST, Ikonomovic MD and Gandy S. Traumatic brain injury--football, warfare, and long-term effects. The New England journal of medicine. 2010;363:1293-6. Johnson VE, Stewart W and Smith DH. Widespread tau and amyloid-beta pathology many years after a single traumatic brain injury in humans. Brain Pathol. 2012;22:142-9. Schrag M and Greer DM. Clinical associations of cerebral microbleeds on magnetic resonance neuroimaging. Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association. 2014;23:2489-2497. Haghbayan H, Boutin A, Laflamme M, Lauzier F, Shemilt M, Moore L, Zarychanski R, Douville V, Fergusson D and Turgeon AF. The Prognostic Value of MRI in Moderate and Severe Traumatic Brain Injury: A Systematic Review and Meta-Analysis. Critical care medicine. 2017;45:e1280-e1288. Izzy S, Mazwi NL, Martinez S, Spencer CA, Klein JP, Parikh G, Glenn MB, Greenberg SM, Greer DM, Wu O and Edlow BL. Revisiting Grade 3 Diffuse Axonal Injury: Not All Brainstem Microbleeds are Prognostically Equal. Neurocritical care. 2017;27:199-207. van Eijck MM, Schoonman GG, van der Naalt J, de Vries J and Roks G. Diffuse axonal injury after traumatic brain injury is a prognostic factor for functional outcome: a systematic review and meta-analysis. Brain Inj. 2018;32:395-402.

In this episode from the ACEP-EQUAL series, guest Dr. Houman Khosravani discusses the concept of a "protected code stroke", how to operationalize the concepts, and how this system can be applied in your local circumstances. Guests: Houman Khosravani, MD PhD Medical Director, Inpatient Stroke Unit Assistant Professor, Division of Neurology, Department of Medicine, University of Toronto Sunnybrook Health Sciences Center Staff Intensivist, Critical Care Medicine, Southlake Regional Health Center Host: Jason Woods, MD Audio Editor: Kellen Vu www.acep.org/equal References 1. Rajendram, P., Notario, L., Reid, C., Wira, C. R., Suarez, J. I., Weingart, S. D., & Khosravani, H. (2020). Crisis Resource Management and High-Performing Teams in Hyperacute Stroke Care. Neurocritical care, 33(2), 338–346. https://doi.org/10.1007/s12028-020-01057-4 2. Codestroke.net

This is a very special episode! I sit down with Lauren Landis to discuss her career and most importantly, how she was a nurse on the same unit that her dad received stroke care. We talk about Lauren's unique background, safe staffing ratios and what her first job was like and spend a majority of time discussing her father, whom suffered a stroke. This case is presented as a case study with knowledge about risk factors, how important an a1c is, what a large vessel stroke means, what neurointerventional care entails and so, so, much more. Lauren describes her experience as a nurse going through tough choices, with appreciation of her prior coworkers and how it is okay to change an environment to better one's own mental health to better care for patients. Lauren's bravery to share this story is not one to pass along-it is a must listen! Lauren is a 2016 graduate of Penn State Mont Alto. She began her career on a Med-Surg Neuro unit before stepping into the world of critical care. Her current area of work is in surgical/trauma intensive care, though she will always have a place in her heart for Neurocritical care patients. She received the Daisy Award in 2017 and a token of recognition by Gift of Life Donor Program for the nursing care of an organ donor in 2019. When Lauren isn't donning/doffing PPE, doing Q1hr neuro checks, or replacing electrolytes, you can find her cooking new recipes, napping away the nightshift hangover, or playing video games with her fiancé, Joshua.

In this episode, we’ll visit the frontiers of vascular neurology, discussing an important but little-understood category of strokes — embolic strokes of undetermined source, or ESUS. We’ll hear from Dr. Hooman Kamel, division chief of neurocritical care at Weill Cornell Medicine. Dr. Kamel is a co-principal investigator for the ARCADIA trial, which is testing anti-thrombotic strategies in patients with cryptogenic stroke and atrial cardiopathy. He was interviewed by ANA Member Michelle Johansen, a vascular neurologist and assistant professor of neurology at Johns Hopkins. Series 1, Episode 11

Dr. Starane Shepherd interviews Dr. Theresa Human at the 2019 Neurocritical Annual Meeting to discuss her session, “Recognition and Management of Neurotoxicities Related to CAR-T Therapy.” This podcast is sponsored by the TTM Academy program at Penn Medicine, an educational initiative to improve care for patients following cardiac arrest and other eurocritical illness using targeted temperature management. This includes live CME workshops, an on-line video educational program, and a free podcast program. Find out more at www.pennttm.com. The NCS Podcast is the official podcast of the Neurocritical Care Society. Our senior producer is Bonnie Rossow. Our host is Fawaz Almufti, and our production staff includes Ramani Balu, Michael Brogan, Joshua Levine, Sarah Stern-Nezer, Benjamin Miller, Starane Shepherd, and Chris Zammit. Our administrative staff include Becca Stickney, Sara Memmen, and Angel Gindele. Music by Mohan Kottapally.

2019 was a big year. The year of the Mueller report. The American college admissions scandals. Brexit. But it was also the year the US Women's team won the World Cup, and lobbied for the equal pay of women and men in sports. It was the year of NMO, in which several pivotal trials showed benefit of disease modulating therapy in this condition. The year Will Smith played Genie in Aladdin. 2019 was a great year. And as we wrap up 2019, this week's episode includes some of the highlights. Enjoy! Produced by James E. Siegler with support from Erika Mejia, Rajat Dhar, and the entire Siegler family. Music courtesy of Axletree, Chris Zabriskie, John Paston, Kevin Mcleod, Josh Woodward, Steve Combs, Lee Rosevere, Scott Holmes, Advent Chamber Orchestra, Coldnoise, and Pachyderm. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast. REFERENCES [BRAIN FOOD] Kennedy DO, Wightman EL, Reay JL, Lietz G, Okello EJ, Wilde A and Haskell CF. Effects of resveratrol on cerebral blood flow variables and cognitive performance in humans: a double-blind, placebo-controlled, crossover investigation. Am J Clin Nutr. 2010;91:1590-7. Devore EE, Kang JH, Breteler MM and Grodstein F. Dietary intakes of berries and flavonoids in relation to cognitive decline. Annals of neurology. 2012;72:135-43. Norton S, Matthews FE, Barnes DE, Yaffe K and Brayne C. Potential for primary prevention of Alzheimer's disease: an analysis of population-based data. The Lancet Neurology. 2014;13:788-94. Morris MC, Tangney CC, Wang Y, Sacks FM, Barnes LL, Bennett DA and Aggarwal NT. MIND diet slows cognitive decline with aging. Alzheimers Dement. 2015;11:1015-22. Valls-Pedret C, Sala-Vila A, Serra-Mir M, Corella D, de la Torre R, Martinez-Gonzalez MA, Martinez-Lapiscina EH, Fito M, Perez-Heras A, Salas-Salvado J, Estruch R and Ros E. Mediterranean Diet and Age-Related Cognitive Decline: A Randomized Clinical Trial. JAMA internal medicine. 2015;175:1094-1103. Newman JC, Covarrubias AJ, Zhao M, Yu X, Gut P, Ng CP, Huang Y, Haldar S and Verdin E. Ketogenic Diet Reduces Midlife Mortality and Improves Memory in Aging Mice. Cell Metab. 2017;26:547-557 e8. Miller MG, Hamilton DA, Joseph JA and Shukitt-Hale B. Dietary blueberry improves cognition among older adults in a randomized, double-blind, placebo-controlled trial. Eur J Nutr. 2018;57:1169-1180. Okkersen K, Jimenez-Moreno C, Wenninger S, Daidj F, Glennon J, Cumming S, Littleford R, Monckton DG, Lochmuller H, Catt M, Faber CG, Hapca A, Donnan PT, Gorman G, Bassez G, Schoser B, Knoop H, Treweek S, van Engelen BGM and consortium O. Cognitive behavioural therapy with optional graded exercise therapy in patients with severe fatigue with myotonic dystrophy type 1: a multicentre, single-blind, randomised trial. The Lancet Neurology. 2018;17:671-680. Radd-Vagenas S, Duffy SL, Naismith SL, Brew BJ, Flood VM and Fiatarone Singh MA. Effect of the Mediterranean diet on cognition and brain morphology and function: a systematic review of randomized controlled trials. Am J Clin Nutr. 2018;107:389-404. Xu W, Wang H, Wan Y, Tan C, Li J, Tan L and Yu JT. Alcohol consumption and dementia risk: a dose-response meta-analysis of prospective studies. Eur J Epidemiol. 2017;32:31-42. Lefevre-Arbogast S, Gaudout D, Bensalem J, Letenneur L, Dartigues JF, Hejblum BP, Feart C, Delcourt C and Samieri C. Pattern of polyphenol intake and the long-term risk of dementia in older persons. Neurology. 2018;90:e1979-e1988. Liu QP, Wu YF, Cheng HY, Xia T, Ding H, Wang H, Wang ZM and Xu Y. Habitual coffee consumption and risk of cognitive decline/dementia: A systematic review and meta-analysis of prospective cohort studies. Nutrition. 2016;32:628-36. [OF MEASLES AND MEN] Murch SH, Anthony A, Casson DH, Malik M, Berelowitz M, Dhillon AP, Thomson MA, Valentine A, Davies SE and Walker-Smith JA. Retraction of an interpretation. Lancet. 2004;363:750. Perry RT and Halsey NA. The clinical significance of measles: a review. The Journal of infectious diseases. 2004;189 Suppl 1:S4-16. Campbell H, Andrews N, Brown KE and Miller E. Review of the effect of measles vaccination on the epidemiology of SSPE. Int J Epidemiol. 2007;36:1334-48. Poland GA and Jacobson RM. The age-old struggle against the antivaccinationists. The New England journal of medicine. 2011;364:97-9. Maglione MA, Das L, Raaen L, Smith A, Chari R, Newberry S, Shanman R, Perry T, Goetz MB and Gidengil C. Safety of vaccines used for routine immunization of U.S. children: a systematic review. Pediatrics. 2014;134:325-37. Bester JC. Measles and Measles Vaccination: A Review. JAMA Pediatr. 2016;170:1209-1215. Bester JC. Not a matter of parental choice but of social justice obligation: Children are owed measles vaccination. Bioethics. 2018;32:611-619. Fournet N, Mollema L, Ruijs WL, Harmsen IA, Keck F, Durand JY, Cunha MP, Wamsiedel M, Reis R, French J, Smit EG, Kitching A and van Steenbergen JE. Under-vaccinated groups in Europe and their beliefs, attitudes and reasons for non-vaccination; two systematic reviews. BMC Public Health. 2018;18:196.  Trump’s tweet: https://twitter.com/realdonaldtrump/status/449525268529815552?lang=en [NON-INFECTIOUS NEUROLOGIC COMPLICATIONS OF ORGAN TRANSPLANT] Senzolo M, Ferronato C and Burra P. Neurologic complications after solid organ transplantation. Transpl Int. 2009;22:269-78. Dhar R. Neurologic complications of transplantation. Handbook of clinical neurology. 2017;141:545-572. Mateen FJ, Dierkhising RA, Rabinstein AA, van de Beek D and Wijdicks EF. Neurological complications following adult lung transplantation. Am J Transplant. 2010;10:908-14. Munoz P, Valerio M, Palomo J, Fernandez-Yanez J, Fernandez-Cruz A, Guinea J and Bouza E. Infectious and non-infectious neurologic complications in heart transplant recipients. Medicine (Baltimore). 2010;89:166-75. Wu Q, Marescaux C, Wolff V, Jeung MY, Kessler R, Lauer V and Chen Y. Tacrolimus-associated posterior reversible encephalopathy syndrome after solid organ transplantation. Eur Neurol. 2010;64:169-77. Dhar R, Young GB and Marotta P. Perioperative neurological complications after liver transplantation are best predicted by pre-transplant hepatic encephalopathy. Neurocritical care. 2008;8:253-8.

The NCS Podcast is partnering with the highly successful Pharmacotherapy of Neurocritical Care Series (PONS) in a limited release to cover pertinent pharmacological topics presented by experts in the field of neurocritical care. Dr. Mehrnaz Pajoumand, Co-Chair of PONS,  is joined by Dr. Salia Farrokh to discuss her presentation in the Pharmacotherapy of Neurocritical Care Series (PONS), "Neurostimulants in the Neurointensive Care Unit." This podcast is sponsored by the TTM Academy program at Penn Medicine, an educational initiative to improve care for patients following cardiac arrest and other eurocritical illness using targeted temperature management. This includes live CME workshops, an on-line video educational program, and a free podcast program. Find out more at www.pennttm.com.   The NCS Podcast is the official podcast of the Neurocritical Care Society. Our senior producer is Bonnie Rossow. Our host is Fawaz Almufti, and our production staff includes Ramani Balu, Michael Brogan, Joshua Levine, Sarah Stern-Nezer, Benjamin Miller, Starane Shepherd, and Chris Zammit. Our administrative staff include Becca Stickney, Sara Memmen, and Angel Gindele. Music by Mohan Kottapally.

Dr. Fawaz Al-Mufti is joined by Dr. Daniel Hanley and Dr. Issam Awad to discuss Dr. Hanley's recent article, "Efficacy and safety of minimally invasive surgery with thrombolysis in intracerebral haemorrhage evacuation (MISTIE III): a randomised, controlled, open-label, blinded endpoint phase 3 trial." This podcast is sponsored by the TTM Academy program at Penn Medicine, an educational initiative to improve care for patients following cardiac arrest and other eurocritical illness using targeted temperature management. This includes live CME workshops, an on-line video educational program, and a free podcast program. Find out more at www.pennttm.com. The NCS Podcast is the official podcast of the Neurocritical Care Society. Our senior producer is Bonnie Rossow. Our host is Fawaz Almufti, and our production staff includes Ramani Balu, Michael Brogan, Joshua Levine, Sarah Stern-Nezer, Benjamin Miller, Starane Shepherd, and Chris Zammit. Our administrative staff include Becca Stickney, Sara Memmen, and Angel Gindele. Music by Mohan Kottapally. Hanley DF, Thompson RE, Rosenblum M, Yenokyan G, et al. Efficacy and safety of minimally invasive surgery with thrombolysis in intracerebral haemorrhage evacuation (MISTIE III): a randomised, controlled, open-label, blinded endpoint phase 3 trial. Lancet. 2019 Mar 9;393(10175):1021-1032.

The NCS Podcast Series - News Flash covers new science in neurocritical care.  ​ ​For the first time, the NCS Podcast is recording directly from the NCS Annual Meeting! For real time updates follow #NCS2019 In this episode, Dr. Benjamin Miller interviews the 2019 NCS Annual Meeting winner of the Cristanne Wijman Young Investigator Award – Erta Beqiri, MD for her abstract titled "Individualizing Cerebral Perfusion Pressure Using the Lower Limit of Reactivity: A CENTER-TBI High-Resolution Sub-study Analysis." The NCS Podcast is the official podcast of the Neurocritical Care Society. Our senior producer is Bonnie Rossow. Our host is Fawaz Almufti, and our production staff includes Ramani Balu, Michael Brogan, Joshua Levine, Sarah Stern-Nezer, Benjamin Miller, Starane Shepherd, and Chris Zammit. Our administrative staff include Becca Stickney, Sara Memmen, and Angel Gindele.

The NCS Podcast Series - News Flash covers new science in neurocritical care.  ​ ​For the first time, the NCS Podcast is recording directly from the NCS Annual Meeting! For real time updates follow #NCS2019 ​ ​Dr. Ramani Balu interviews Dr. Benjamin Abella at the 2019 Annual Meeting in Vancouver. They discuss the top five TTM post cardiac arrest care common issues that may occur. The NCS Podcast is the official podcast of the Neurocritical Care Society. Our senior producer is Bonnie Rossow. Our host is Fawaz Almufti, and our production staff includes Ramani Balu, Michael Brogan, Joshua Levine, Sarah Stern-Nezer, Benjamin Miller, Starane Shepherd, and Chris Zammit. Our administrative staff include Becca Stickney, Sara Memmen, and Angel Gindele.

The NCS Podcast is partnering with the highly successful Pharmacotherapy of Neurocritical Care Series (PONS) in a limited release to cover pertinent pharmacological topics presented by experts in the field of neurocritical care. Dr. Mehrnaz Pajoumand, Co-Chair of PONS, interviews Dr. Ruben Santiago on his PONS presentation "Beyond the Horizon: Exploring the Next Frontier in Anticoagulation Reversal" discussing reversal strategies for direct oral anti-coagulant, DOAC, associated hemorrhage. The NCS Podcast is the official podcast of the Neurocritical Care Society. Our senior producer is Bonnie Rossow. Our host is Fawaz Almufti, and our production staff includes Ramani Balu, Michael Brogan, Joshua Levine, Sarah Stern-Nezer, Benjamin Miller, Starane Shepherd, and Chris Zammit. Our administrative staff include Becca Stickney, Sara Memmen, and Angel Gindele. Music by Lee Roosevere.  

Dr. Chris Zammit interviews Professor Alistair Nichol on the methods and results of the recently published POLAR trial, which sought to determine the safety and efficacy of early hypothermia in patients with severe TBI. The NCS Podcast is the official podcast of the Neurocritical Care Society. Our senior producer is Jim Siegler. Our host is Fawaz Almufti, and our production staff includes Ramani Balu, Michael Brogan, Joshua Levine, Sarah Stern-Nezer, Benjamin Miller, Starane Shepherd, and Chris Zammit. Our administrative staff include Becca Stickney, Sara Memmen, and Angel Gindele. Music by Lee Roosevere. Cooper DJ, Nichol AD, Bailey M, et al. Effect of Early Sustained Prophylactic Hypothermia on Neurologic Outcomes Among Patients With Severe Traumatic Brain Injury: The POLAR Randomized Clinical Trial. JAMA : the journal of the American Medical Association. 2018;320:2211-2220.

This week on the BrainWaves podcast, finally...a REAL show about BRAINWAVES! Dr. Carolina Maciel, of the University of Florida, schools Jim Siegler on how to read EEG and interpret abnormal patterns across the ictal-interictal continuum. Produced by James E. Siegler and Carolina Maciel. Music courtesy of Chris Zabriskie, Montplaisir, Rafael Archangel, Steve Combs, Unheard Music Concepts, and Siddhartha. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast. REFERENCES Chong DJ and Hirsch LJ. Which EEG patterns warrant treatment in the critically ill? Reviewing the evidence for treatment of periodic epileptiform discharges and related patterns. Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society. 2005;22:79-91. Benbadis SR, LaFrance WC, Jr., Papandonatos GD, Korabathina K, Lin K, Kraemer HC and Workshop NEST. Interrater reliability of EEG-video monitoring. Neurology. 2009;73:843-6. Hirsch LJ, LaRoche SM, Gaspard N, Gerard E, Svoronos A, Herman ST, Mani R, Arif H, Jette N, Minazad Y, Kerrigan JF, Vespa P, Hantus S, Claassen J, Young GB, So E, Kaplan PW, Nuwer MR, Fountain NB and Drislane FW. American Clinical Neurophysiology Society's Standardized Critical Care EEG Terminology: 2012 version. Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society. 2013;30:1-27. Gaspard N, Hirsch LJ, LaRoche SM, Hahn CD, Westover MB and Critical Care EEGMRC. Interrater agreement for Critical Care EEG Terminology. Epilepsia. 2014;55:1366-73. Newey CR, Sahota P and Hantus S. Electrographic Features of Lateralized Periodic Discharges Stratify Risk in the Interictal-Ictal Continuum. Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society. 2017;34:365-369. Rubinos C, Reynolds AS and Claassen J. The Ictal-Interictal Continuum: To Treat or Not to Treat (and How)? Neurocritical care. 2018;29:3-8. Gerber PA, Chapman KE, Chung SS, Drees C, Maganti RK, Ng YT, Treiman DM, Little AS and Kerrigan JF. Interobserver agreement in the interpretation of EEG patterns in critically ill adults. Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society. 2008;25:241-9. Beniczky S, Hirsch LJ, Kaplan PW, Pressler R, Bauer G, Aurlien H, Brogger JC and Trinka E. Unified EEG terminology and criteria for nonconvulsive status epilepticus. Epilepsia. 2013;54 Suppl 6:28-9. Claassen J. How I treat patients with EEG patterns on the ictal-interictal continuum in the neuro ICU. Neurocritical care. 2009;11:437-44.

This month on the NCS Podcast, Dr. Chris Zammit interviews Dr. David Roh on their retrospective evaluation of ABO blood type on the risk of hematoma expansion in intracerebral hemorrhage. The NCS Podcast is the official podcast of the Neurocritical Care Society. Our senior producer is Jim Siegler. Our host is Fawaz Almufti, and our production staff includes Ramani Balu, Michael Brogan, Joshua Levine, Sarah Stern-Nezer, Benjamin Miller, Starane Shepherd, and Chris Zammit. Our administrative staff include Becca Stickney, Sara Memmen, and Angel Gindele. Music by Lee Roosevere. Roh D, Martin A, Sun CH, Eisenberger A, Boehme A, Elkind MSV, Pucci JU, Murthy S, Kamel H, Sansing L, Park S, Agarwal S, Connolly ES, Claassen J, Hod E and Francis RO. ABO Blood Type and Hematoma Expansion After Intracerebral Hemorrhage: An Exploratory Analysis. Neurocritical care. 2019;31:66-71.

In this Reconstructing Death series, I talk with a range of LDS spiritual, palliative and health care professionals whose work is with those at the threshold of death.  Each of them explores their evolving understandings of dying and death as a result of both their professional work and their personal faith development. Dr Julia Durrant:  Neurocritical care attending physician:  Oregon Dr Julia Durrant is an attending physician in neurocritical care at a university hospital in Oregon.  Julia has attended hundreds of deaths and she talks wisely about the point at which religion, faith and science intersect which has caused her to strongly believe that God is not orchestrating anyone's death. 

In this installment of the NCS Podcast, Dr. Starane Shepherd interviews Dr. Michael Reznik on their investigation as to the clinical impact of agitation and fluctuations in consciousness following subarachnoid hemorrhage. The NCS Podcast is the official podcast of the Neurocritical Care Society. Our senior producer is Jim Siegler. Our host is Fawaz Almufti, and our production staff includes Ramani Balu, Michael Brogan, Joshua Levine, Sarah Stern-Nezer, Benjamin Miller, Starane Shepherd, and Chris Zammit. Our administrative staff include Becca Stickney, Sara Memmen, and Angel Gindele. Music by Lee Roosevere. Reznik ME, Mahta A, Schmidt JM, Frey HP, Park S, Roh DJ, Agarwal S and Claassen J. Duration of Agitation, Fluctuations of Consciousness, and Associations with Outcome in Patients with Subarachnoid Hemorrhage. Neurocritical care. 2018;29:33-39.

This month on the NCS Podcast, Dr. Sara Stern-Nezer interviews Dr. Baxter Allen about his recently published investigation exploring the risk of seizures following clipping or endovascular coiling of ruptured intracranial aneurysms. The NCS Podcast is the official podcast of the Neurocritical Care Society. Our senior producer is Jim Siegler. Our host is Fawaz Almufti, and our production staff includes Michael Brogan, Starane Shepherd, Benjamin Miller, Chris Zammit, and Ramani Balu. Our administrative staff include Becca Stickney, Sara Memmen, and Angel Gindele. Music by Lee Roosevere. Allen BB, Forgacs PB, Fakhar MA, Wu X, Gerber LM, Boddu S, et al. Association of seizure occurrence with aneurysm treatment modality in aneurysmal subarachnoid hemorrhage patients. Neurocritical care. 2018;29:62-68

Current guidelines recommend that cerebral perfusion pressure be maintained between 60 and 70 mmHg in patients with severe TBI, but evidence is lacking. This month on the NCS podcast, Dr. Brogan interviews Dr. Andreas Kramer regarding his retrospective cohort study which attempts to better elucidate optimal cerebral perfusion parameters. The NCS Podcast is the official podcast of the Neurocritical Care Society. Our senior producer is Jim Siegler. Our production staff includes Fawaz Almufti, Becca Stickney, Michael Brogan, Starane Shepherd, Benjamin Miller, and Ramani Balu. Music by Lee Roosevere. Kramer AH, Couillard PL, Zygun DA, Aries MJ, and Gallagher CN. Continuous Assessment of "Optimal" Cerebral Perfusion Pressure in Traumatic Brain Injury: A Cohort Study of Feasibility, Reliability, and Relation to Outcome. Neurocritical Care. 2019;30:51-61.

Following refractory status epilepticus, the ictal-interictal EEG continuum can be as puzzling to intensivists as it can be to world-renowned epileptologists. Should you re-challenge with aggressive intravenous anesthetics? Or attempt to de-escalate therapy? This week on the NCS podcast, Dr. Starane Shepherd interviews Dr. Alvin Das on his recently published case series in Neurocritical Care that seeks to answer these questions. The NCS Podcast is the official podcast of the Neurocritical Care Society. Our senior producer is Jim Siegler. Our production staff includes Fawaz Almufti, Becca Stickney, Michael Brogan, Starane Shepherd, Benjamin Miller, and Ramani Balu. Music by Lee Roosevere. Das AS, Lee JW, Rosenthal ES and Vaitkevicius H. Successful Wean Despite Emergence of Ictal-Interictal EEG Patterns During the Weaning of Prolonged Burst-Suppression Therapy for Super-Refractory Status Epilepticus. Neurocritical care. 2018;29:452-462.

In the second half of our two-part series on complications of organ transplantation, Dr. Raj Dhar (Neurocritical Care, Washington University in St. Louis) discusses his experience managing the non-infectious complications of organ transplantation--from drug toxicities to multi-disciplinary medical care. Produced by James E. Siegler and Raj Dhar. Music by Steve Combs, Lee Rosevere, and Scott Holmes. Sound effects by Mike Koenig and Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast. REFERENCES Senzolo M, Ferronato C and Burra P. Neurologic complications after solid organ transplantation. Transpl Int. 2009;22:269-78. Dhar R. Neurologic complications of transplantation. Handbook of clinical neurology. 2017;141:545-572. Mateen FJ, Dierkhising RA, Rabinstein AA, van de Beek D and Wijdicks EF. Neurological complications following adult lung transplantation. Am J Transplant. 2010;10:908-14. Munoz P, Valerio M, Palomo J, Fernandez-Yanez J, Fernandez-Cruz A, Guinea J and Bouza E. Infectious and non-infectious neurologic complications in heart transplant recipients. Medicine (Baltimore). 2010;89:166-75. Wu Q, Marescaux C, Wolff V, Jeung MY, Kessler R, Lauer V and Chen Y. Tacrolimus-associated posterior reversible encephalopathy syndrome after solid organ transplantation. Eur Neurol. 2010;64:169-77. Dhar R, Young GB and Marotta P. Perioperative neurological complications after liver transplantation are best predicted by pre-transplant hepatic encephalopathy. Neurocritical care. 2008;8:253-8.

This week on the NCS podcast, Dr. Ramani Balu interviews Dr. Brandon Foreman about his recently published observational cohort study on multimodality monitoring in severe TBI. Together, they discuss the practical aspects (and limitations) of this increasingly popular tool in neurocritical care. The NCS Podcast is the official podcast of the Neurocritical Care Society. Our senior producer is Jim Siegler. Our production staff includes Fawaz Almufti, Becca Stickney, Michael Brogan, Starane Shepherd, Benjamin Miller, and Ramani Balu. Music by Lee Rosevere. Foreman B, Ngwenya LB, Stoddard E, Hinzman JM, Andaluz N and Hartings JA. Safety and Reliability of Bedside, Single Burr Hole Technique for Intracranial Multimodality Monitoring in Severe Traumatic Brain Injury. Neurocritical care. 2018. Epub ahead of print.

Hypoxemia in ICU patients has long been associated with poor clinical outcomes, but data pertaining to the prognosis with hyperoxia are lacking. This week on the NCS podcast, Dr. Levine interviews Dr. Andrew Udy on his multicenter retrospective cohort study that sought to clarify this relationsnhip. The NCS Podcast is the official podcast of the Neurocritical Care Society. Our senior producer is Jim Siegler. Our production staff includes Joshua Levine, Becca Stickney, Michael Brogan, Starane Shepherd, Benjamin Miller, and Ramani Balu. Music by Lee Rosevere. O Briain D, Nickson C, Pilcher DV and Udy AA. Early Hyperoxia in Patients with Traumatic Brain Injury Admitted to Intensive Care in Australia and New Zealand: A Retrospective Multicenter Cohort Study. Neurocritical care. 2018. Epub ahead of print.

A wise man once said, "traditions are often mistakes made more than once." To correct some of these traditions, Dr. Geert Meyfroidt shares his experience with Dr. Fawaz Almufti by describing 10 of the most important misunderstandings in neurocritical care. The NCS Podcast is the official podcast of the Neurocritical Care Society. Our senior producer is Jim Siegler. Our production staff includes Joshua Levine, Becca Stickney, Michael Brogan, Starane Shepherd, Benjamin Miller, and Ramani Balu. Music by Lee Rosevere. Meyfroidt G, Menon D and Turgeon AF. Ten false beliefs in neurocritical care. Intensive care medicine. 2018. Epub ahead of print.

Unfortunately, stroke is all too common. Nearly 1 million new strokes are diagnosed in the US each year. And this means that complications of stroke--even if rare--may also be common. One such complication is hemorrhagic transformation. This week, Dr. Ava Liberman reviews a clinical case of hemorrhage following ischemic stroke. Produced by James E. Siegler. Music by Ghost, Kevin McLeod, and Scott Holmes. Voiceover by David Manly. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision making. REFERENCES Benjamin EJ, Virani SS, Callaway CW, Chamberlain AM, Chang AR, Cheng S, Chiuve SE, Cushman M, Delling FN, Deo R, de Ferranti SD, Ferguson JF, Fornage M, Gillespie C, Isasi CR, Jimenez MC, Jordan LC, Judd SE, Lackland D, Lichtman JH, Lisabeth L, Liu S, Longenecker CT, Lutsey PL, Mackey JS, Matchar DB, Matsushita K, Mussolino ME, Nasir K, O'Flaherty M, Palaniappan LP, Pandey A, Pandey DK, Reeves MJ, Ritchey MD, Rodriguez CJ, Roth GA, Rosamond WD, Sampson UKA, Satou GM, Shah SH, Spartano NL, Tirschwell DL, Tsao CW, Voeks JH, Willey JZ, Wilkins JT, Wu JH, Alger HM, Wong SS, Muntner P, American Heart Association Council on E, Prevention Statistics C and Stroke Statistics S. Heart Disease and Stroke Statistics-2018 Update: A Report From the American Heart Association. Circulation. 2018;137:e67-e492. Frontera JA, Lewin JJ, 3rd, Rabinstein AA, Aisiku IP, Alexandrov AW, Cook AM, del Zoppo GJ, Kumar MA, Peerschke EI, Stiefel MF, Teitelbaum JS, Wartenberg KE and Zerfoss CL. Guideline for Reversal of Antithrombotics in Intracranial Hemorrhage: A Statement for Healthcare Professionals from the Neurocritical Care Society and Society of Critical Care Medicine. Neurocritical care. 2016;24:6-46. Prabhakaran S, Gupta R, Ouyang B, John S, Temes RE, Mohammad Y, Lee VH and Bleck TP. Acute brain infarcts after spontaneous intracerebral hemorrhage: a diffusion-weighted imaging study. Stroke; a journal of cerebral circulation. 2010;41:89-94.

Author: Peter Bakes, M.D. Educational Pearls:   Epidural hematomas have a characteristic convex appearance on CT while a subdural hematoma will have a concave appearance. Indications for operative intervention for subdural hematoma may include: >5 mm midline shift, over 10 mm in thickness, comatose with ICP >20, or patient neurologic deterioration.   References Bullock, M. R. et. al. . Surgical management of acute subdural hematomas. 2006. Neurosurgery, 58(SUPPL. 3). DOI: 10.1227/01.NEU.0000210364.29290.C9. Huang KT, Bi WL, Abd-El-Barr M, Yan SC, Tafel IJ, Dunn IF, Gormley WB. The Neurocritical and Neurosurgical Care of Subdural Hematomas. Neurocrit Care. 2016. 24(2):294-307. doi: 10.1007/s12028-015-0194-x.

Dr. Brogan interviews Dr. Kurczewski in this month's program on her recent study comparing the efficacy of clevidipine versus nicardipine in a neurointensive care population. The NCS Podcast is the official podcast of the Neurocritical Care Society. Our senior producer is Jim Siegler. Our production staff includes Joshua Levine, Becca Stickney, Michael Brogan, Starane Shepherd, Benjamin Miller, and Ramani Balu. Music by Lee Rosevere. Finger JR, Kurczewski LM and Brophy GM. Clevidipine Versus Nicardipine for Acute Blood Pressure Reduction in a Neuroscience Intensive Care Population. Neurocritical care. 2017;26:167-173.

Prognostic biomarkers following traumatic brain injury can be limited, but much can be gleaned from certain neuroimaging features. This week, Dr. Ramani Balu interviews Dr. Saef Izzy on what can be inferred from the burden and location of traumatic microhemorrhages in patients after TBI. The NCS Podcast is the official podcast of the Neurocritical Care Society. Our senior producer is Jim Siegler. Our production staff includes Joshua Levine, Becca Stickney, Michael Brogan, Starane Shepherd, Benjamin Miller, and Ramani Balu. Music by Lee Rosevere. Izzy S, Mazwi NL, Martinez S, Spencer CA, Klein JP, Parikh G, Glenn MB, Greenberg SM, Greer DM, Wu O and Edlow BL. Revisiting Grade 3 Diffuse Axonal Injury: Not All Brainstem Microbleeds are Prognostically Equal. Neurocritical care. 2017;27:199-207.  

Dr. Jim Siegler interviews Dr. David Coughlin about his successful quality improvement pilot study aimed at preventing early NICU readmissions ("bouncebacks") when patients are transferred to lower levels of service. The NCS Podcast is the official podcast of the Neurocritical Care Society. Our senior producer is Jim Siegler. Our production staff includes Joshua Levine, Becca Stickney, Michael Brogan, Starane Shepherd, Benjamin Miller, and Ramani Balu. Music by Lee Rosevere. Coughlin DG, Kumar MA, Patel NN, Hoffman RL and Kasner SE. Preventing Early Bouncebacks to the Neurointensive Care Unit: A Retrospective Analysis and Quality Improvement Pilot. Neurocritical care. 2017; Epub ahead of print.  

Dr. Starane Shepherd explores new therapeutic strategies for refractory status epilepticus with Dr. Maysa Basha, and in particular, her center's experience with acute resective surgery. The NCS Podcast is the official podcast of the Neurocritical Care Society. Our senior producer is Jim Siegler. Our production staff includes Joshua Levine, Becca Stickney, Michael Brogan, Starane Shepherd, Benjamin Miller, and Ramani Balu. Music by Lee Rosevere. Basha MM, Suchdev K, Dhakar M, Kupsky WJ, Mittal S and Shah AK. Acute Resective Surgery for the Treatment of Refractory Status Epilepticus. Neurocritical care. 2017; Epub ahead of print.

Dr. Joshua Levine speaks with Dr. Deena Nasr, of the Mayo Clinic, on her retrospective cohort and literature review on the clinical features of patients with neurogenic stress cardiomyopathy. The NCS Podcast is the official podcast of the Neurocritical Care Society. Our senior producer is Jim Siegler. Our production staff includes Joshua Levine, Becca Stickney, Michael Brogan, Starane Shepherd, Benjamin Miller, and Ramani Balu. Music by Lee Rosevere. Nasr DM, Tomasini S, Prasad A and Rabinstein AA. Acute Brain Diseases as Triggers for Stress Cardiomyopathy: Clinical Characteristics and Outcomes. Neurocritical care. 2017; Epub ahead of print.

Dr. David Coughlin returns for this week's Teaching Through Clinical Cases to discuss the management of a delirious patient with a hyperkinetic movement disorder. Produced by James E. Siegler. Music by Hyson, Josh Woodward, Komiku and Peter Rudenko. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision making. REFERENCES Mills KC. Serotonin syndrome. American family physician. 1995;52:1475-1482 Radomski J, Dursun S, Reveley M, Kutcher S. An exploratory approach to the serotonin syndrome: An update of clinical phenomenology and revised diagnostic criteria. Medical hypotheses. 2000;55:218-224 Dunkley EJ, Isbister GK, Sibbritt D, Dawson AH, Whyte IM. The hunter serotonin toxicity criteria: Simple and accurate diagnostic decision rules for serotonin toxicity. QJM : monthly journal of the Association of Physicians. 2003;96:635-642 Boyer EW, Shannon M. The serotonin syndrome. The New England journal of medicine. 2005;352:1112-1120 Dosi R, Ambaliya A, Joshi H, Patell R. Serotonin syndrome versus neuroleptic malignant syndrome: A challenging clinical quandary. BMJ case reports. 2014;2014:bcr2014204154 Lappin RI, Auchincloss EL. Treatment of the serotonin syndrome with cyproheptadine. The New England journal of medicine. 1994;331:1021-1022 Pedavally S, Fugate JE, Rabinstein AA. Serotonin syndrome in the intensive care unit: Clinical presentations and precipitating medications. Neurocritical care. 2014;21:108-113 Ables AZ, Nagubilli R. Prevention, recognition, and management of serotonin syndrome. American family physician. 2010;81:1139-1142

Dr. Ramani Balu is joined by Dr. Andrea Morotti for the inaugural episode of the Neurocritical Care Society Podcast to discuss Dr. Morotti's recently published paper, "Lymphopenia, Infectious Complications, and Outcome in Spontaneous Intracerebral Hemorrhage." The NCS Podcast is the official podcast of the Neurocritical Care Society. Our senior producer is Jim Siegler. Our production staff includes Joshua Levine, Becca Stickney, Michael Brogan, Starane Shepherd, Benjamin Miller, and Ramani Balu. Music by Lee Rosevere. Morotti A, Marini S, Jessel MJ, Schwab K, Kourkoulis C, Ayres AM, Gurol ME, Viswanathan A, Greenberg SM, Anderson CD, Goldstein JN and Rosand J. Lymphopenia, Infectious Complications, and Outcome in Spontaneous Intracerebral Hemorrhage. Neurocritical care. 2017;26:160-166.

About the Talent: Dr. Lee Schwamm is Professor of Neurology at Harvard Medical School, and Executive Vice Chairman of Neurology at Massachusetts General Hospital, where he is the Director of Stroke Services. He also acts as Director of the Partners TeleStroke Network, a network which currently provides acute stroke consultation services to 27 rural and community hospitals in Massachusetts and Northern New England and was the first major TeleStroke network in the US. He plays a pivotal role in the development and leadership of the American Heart Association's National Get With the Guidelines-Stroke program, is chair of the clinical workgroup and co-chair of Mission: Lifeline Stroke. His clinical interests are stroke and cerebrovascular disease, stroke in the young, primary and secondary stroke prevention, cryptogenic stroke and unusual causes of stroke. He received his M.D. from Harvard Medical School in 1991. He completed his neurology residency in 1995 and NeuroCritical Care Fellowship in 1996, both at Massachusetts General Hospital. He is board certified in neurology, Neurocritical care and vascular neurology. These interviews are provided by the American Heart Association

Undertaking a decompressive crainectomy is perhaps one of the most challenging decisions we face within critical care, we don't know if we should do the operation, and even if we think we should we don't know when, or even how. Perhaps more importantly we don't do the operation, the neurosurgeons do, but we frequently put them in the position of doing the operation when we are at our wits end, or they do the operation without asking us when we still feel we have space to play. How can we resolve this, in a workplace environment which is already fraught with competing interests, beliefs, values and approaches? Evidence based medicine isn't going to provide an answer soon and it is unlikely that a superficial approach to improving teamwork will either. An important component will be the future structure of clinical training, our current systems reflect the way hospitals worked decades ago and the specialties we now have exist almost independently of the training which leads to consultant posts. Training should involve exposure to collegiate decision making and consensus building but this will be difficult to achieve within our current nationally co-ordinated training schemes.

Martin -PRO- : The management of severe traumatic brain injury (TBI) has undergone extensive revision following evidence that longstanding and established practices are not as efficacious or innocuous as previously believed. Very few specific interventions have been shown to improve outcome in large randomized controlled trials and, with the possible exception of avoidance of hypotension and hypoxaemia, most are based on observational studies or analysis of physiology and pathophysiology. Further, the substantial temporal and regional pathophysiological heterogeneity after TBI means that some interventions may be ineffective, unnecessary or even harmful in certain patients at certain times. Improved understanding of pathophysiology and advances in neuromonitoring and imaging techniques have led to the introduction of more effective and individualised treatment strategies that have translated into improved outcomes for patients. In particular, the sole goal of identifying and treating intracranial hypertension has been superseded by a focus on the prevention of secondary brain insults using a systematic, stepwise approach to maintenance of adequate cerebral perfusion and oxygenation. As well as being used to guide treatment interventions, multimodal neuromonitoring also gives clinicians confidence to withhold potentially dangerous therapy in those with no evidence of brain ischemia/hypoxia or metabolic disturbance. The days of blind adherence to generic physiological targets in the management of severe TBI have been replaced by an individualised approach to optimisation of physiology which has translated into improved outcomes for patients.   Mark -CON- : The New England Journal of Medicine has published a number of articles recently that demonstrate no benefit from classic neurotrauma interventions (ICP monitoring, cooling, decompression). This is because factors such as ICP and CPP are associated with bad outcome by association rather than causation. This debate will demonstrate that critical care just complicates things and it is high time for the randomised trial between the very best Neurocritical care and NOB therapy (Naso-pharyngeal, Oxygen and a Blanket).

Today we welcome one of the gurus in anti-coagulant reversal, John J. Lewin. Dr. Lewin recently published one of the recent landmark articles in the field of Neurocritical care: "Guideline for Reversal of Antithrombotics in Intracranial Hemorrhage". Today he is gracious enough to spend 60 minutes with us, and not a second can be missed if you EVER expect to take care of a patient with a head bleed on AC!!

1) Natural history of cavernous malformation: Systematic review and meta-analysis of 25 studies2) e-Pearl topic: Neurologic manifestations of hereditary hemorrhagic telangiectasia3) Topic of the month: Neurology Today story about new Center for Disease Control guidelines on prescribing opioids (Part 1)This podcast for the Neurology Journal begins and closes with Dr. Robert Gross, Editor-in-Chief, briefly discussing highlighted articles from the print issue of Neurology. In the second segment Dr. Matthew Flaherty interviews Dr. Loch Macdonald about his paper on review and meta-analysis of 25 studies about the natural history of cavernous malformation. Dr. Adam Numis is reading our e-Pearl of the week about neurologic manifestations of hereditary hemorrhagic telangiectasia. Dr. Ted Burns interviews Dr. Gary Franklin about a Neurology Today story on the topic of the new Center for Disease Control guidelines on prescribing opioids (Part 1).DISCLOSURES: Dr. Flaherty serves on the scientific advisory board for DSMB member, I-DEF Trial (NINDS sponsored ICH treatment trial); has a patent pending, non-invasive CNS monitor; owns company stock as co-founder of SENSE Diagnostics, LLC (our product is currently investigational and not on the market); serves on the speakers' bureau of CSL Behring and Janssen; receives research support from American Heart Association, Pfizer Inc, Bristol-Myers Squibb, NIH and as Principal Investigator of a phase II, NINDS funded trial testing recombinant activated factor VII for treatment of intracerebral hemorrhage where study drug is supplied by Novo Nordisk.Dr. Macdonald serves as an editorial board member of Stroke, Journal of Neurosurgery, Neurosurgery, Journal of cerebral blood flow and metabolism, Neurocritical care, World Neurosurgery, Surgical Neurology International, Translational stroke research and Cerebrovascular diseases; treats unruptured aneurysm patients (1% effort); holds stock options in Edge Therapeutics, Inc; has a patent for treatment of delayed cerebral ischemia and subdural hemorrhage, intracranial drug delivery systems; receives research support from Canadian Institutes of Health Research, Brain Aneurysm Foundation, Heart and Stroke Foundation of Canada and Physicians Services Incorporated Foundation.Dr. Numis serves on the editorial team for the Neurology® Resident and Fellow Section.Dr. Ted Burns serves as Podcast Editor for Neurology®; and has received research support for consulting activities with UCB, CSL Behring, Walgreens and Alexion Pharmaceuticals, Inc.Dr. Franklin serves as an editorial board member of Neuroepidemiology; serves on the Levels of Evidence Team for Neurology®; is a consultant for the California State Compensation Insurance Fund; receives research support from the Centers for Disease Control and Prevention.

The Force is strong with this one… Despite years of research and new technology, the adjusted mortality rate for traumatic brain injury remains near 25%. Currently, primary injury occurs before we can intervene, and all our pre-hospital, ED and ICU care is directed towards preventing remarkably complicated and poorly understood secondary injuries. TBI is a heterogenous group of diseases often treated homogenously. You too can master the ways of the Force, by reviewing the Top 10 items you need to know to care for your next patient with a severe traumatic brain injury. Topics covered will include the most up to date evidence, anticoagulation reversal, early aggressive care, and future directions. Become a master of this complicated disease process in your clinical practice.

In this Traumacast, Drs. Levi Procter and Andrew Bernard interview Dr. Joshua Levine, Chief of Neurocritical Care and the University of Pennsylvania regarding the critical care management of traumatic brain injury.  Dr. Levine is a nationally recognized expert in Neurocritical care. Recently, the ACS COT updated their guidelines on the management of severe traumatic brain injury. We discuss the new-tiered therapies, the pros and cons and how to apply this in your practice.  Supplementary MaterialsACS TQIP - Best Practices in the Management of Traumatic Brain Injury

This neuroRAGE Special Edition is 82 min 03 sec long and includes: Introduction, ‘What's bubbling up?' ‘Traumatic Brain Injury and a bit about the Spine' ‘ICP Monitoring' ‘Intracerebral haemorrhage and Subarachnoid Haemorrhage' A ‘smorgasbord' of other neurocritical care questions, including the ‘cranial screwtop manoeuvre' ‘A blast from the past' by Oli Flower on the origins of the EEG ‘Words of Wisdom' from Mark Wilson

A discussion with Dr. Sandeep Khot and Dr.Elizabeth Cahill from Harborview Medical Center, Seattle regarding postcardaic arrest management through the use of prognostic tools and markers, including the physical examination, evaluation of myoclonus, electroencephalogram monitoring, somatosensory-evoked potentials, biochemical markers of neuronal injury, and neuroimaging.   Click here to read the full article.  

Michael Weinstein, MD, FACS, FCCP, speaks with David Hwang, MD, Assistant Professor of Neurology in the Division of Neurocritical Care and Emergency Neurology at the Yale School of Medicine.

Michael Weinstein, MD, FACS, FCCP, speaks with David Hwang, MD, Assistant Professor of Neurology in the Division of Neurocritical Care and Emergency Neurology at the Yale School of Medicine.

Seppelt joins the dots on the big picture of neuro-critical airway management.

Oli Flower gives an iconoclastic view of neurocritical care. This is a talk that was given at the College of Intensive Care Medicine's ASM in Wellington in June 2013. It focuses on three aspects of traumatic brain injury management: prognostication, transfusion thresholds and the role of ICP monitoring. For the references and more click here.