A5067304125- Traumatic Brain Injury and Neurovascular Disturbances
- EEG and Brain-Computer Interfaces
- Epilepsy research and treatment
- Intracranial Aneurysms: Treatment and Complications
- Intracerebral and Subarachnoid Hemorrhage Research
- Pharmacological Effects and Toxicity Studies
- Acute Ischemic Stroke Management
- Neurosurgical Procedures and Complications
- Neonatal and fetal brain pathology
- Cerebrospinal fluid and hydrocephalus
- Thermal Regulation in Medicine
- Clinical Reasoning and Diagnostic Skills
- Innovations in Medical Education
- Takotsubo Cardiomyopathy and Associated Phenomena
- Cardiac Arrest and Resuscitation
- Respiratory Support and Mechanisms
- Parkinson's Disease and Spinal Disorders
- Neural dynamics and brain function
- Traumatic Brain Injury Research
- Vascular Malformations Diagnosis and Treatment
- Neurology and Historical Studies
- Neuroscience, Education and Cognitive Function
- Neuroscience and Neuropharmacology Research
- Blind Source Separation Techniques
- Spinal Hematomas and Complications
Thomas Jefferson University
2016-2024
Maastricht University
2024
Thomas Jefferson University Hospital
2015-2024
Texas Children's Hospital
2023
Baylor College of Medicine
2023
Washington University in St. Louis
2009-2023
Oregon Health & Science University
2023
Nationwide Children's Hospital
2023
The Ohio State University
2023
Philippine General Hospital
2023
INTRODUCTION In the early 2000s, a subcommittee of American Clinical Neurophysiology Society (ACNS) set out to “standardize terminology periodic and rhythmic EEG patterns in critically ill aid future research involving such patterns.” The initial proposed was published 2005.1 This presented at many meetings on several continents, subjected multiple rounds testing interrater reliability, underwent revisions, then as an ACNS guideline 2013.2 Interrater agreement 2012 version (published 2013)...
Vasospasm is an important complication of subarachnoid hemorrhage, but variably defined in the literature.We studied 580 patients with hemorrhage and identified those with: (1) symptomatic vasospasm, as clinical deterioration deemed secondary to vasospasm after other causes were eliminated; (2) delayed cerebral ischemia (DCI), or infarction on CT attributable vasospasm; (3) angiographic spasm, seen digital subtraction angiography; (4) transcranial Doppler (TCD) any mean flow velocity >120...
Therapeutic temperature modulation is widely used in neurocritical care but commonly causes shivering, which can hamper the cooling process and result increases systemic metabolism. We sought to validate a grading scale assist monitoring control of shivering.A simple 4-point Bedside Shivering Assessment Scale was validated against continuous assessments resting energy expenditure, oxygen consumption, carbon dioxide production as measured by indirect calorimetry. for fever or induction...
<h3>Importance</h3> Periodic and rhythmic electroencephalographic patterns have been associated with risk of seizures in critically ill patients. However, specific features that confer higher seizure remain unclear. <h3>Objective</h3> To analyze the association distinct characteristics periodic seizures. <h3>Design, Setting, Participants</h3> We reviewed recordings from 4772 adults 3 academic medical centers February 2013 to September 2015 performed a multivariate analysis determine...
To identify risk factors for refractory fever after subarachnoid hemorrhage (SAH), and to determine the impact of temperature elevation on outcome.We studied a consecutive cohort 353 patients with SAH maximum daily (T(max)) recorded at least 7 days between 0 10. Fever (>38.3 degrees C) was routinely treated acetaminophen conventional water-circulating cooling blankets. We calculated T(max) above 37.0 C, defined extreme as excess 38.3 C. Global outcome 90 evaluated modified Rankin Scale...
Hyperglycemia is common after subarachnoid hemorrhage (SAH). The extent to which prolonged hyperglycemia contributes in-hospital complications and poor outcome SAH unknown.We studied an inception cohort of 281 patients with initial serum glucose level obtained within 3 days onset who had at least 7 daily measurements between 0 10. We defined mean burden (GB) as the average peak >5.8 mmol/L (105 mg/dL). Hospital were recorded prospectively, 3-month was assessed modified Rankin scale.The...
The authors sought to determine frequency, risk factors, and impact on outcome of asymptomatic cerebral infarction due vasospasm after subarachnoid hemorrhage (SAH).The prospectively studied 580 patients with SAH admitted their center between July 1996 May 2002. Delayed ischemia (DCI) from was defined as 1) a new focal neurological deficit or decrease in level consciousness, 2) infarct revealed by follow-up CT imaging, both, excluding causes other than vasospasm. Outcome at 3 months assessed...
Wartenberg, Katja E; Schmidt, J Michael; Fernandez, Andres; Claassen, Jan; Ostapkovich, Noeleen D; Palestrant, David; Augusto, Parra; Mayer, Stephan A; Badjatia, Neeraj; Frontera, Jennifer A Author Information
IMPACT OF NOSOCOMIAL INFECTIOUS COMPLICATIONS AFTER SUBARACHNOID HEMORRHAGE Jennifer A. Frontera, M.D., M.D. 1Departments of Neurosurgery and Neurology, Neurological Intensive Care Unit, Mount Sinai School Medicine, New York, York *Reprint requests: Department Neurosurgery, One Gustave Levy Place, Box 1136, NY 10029. Email: Jennifer.Frontera@mountsinai.org Search for other works by this author on: Oxford Academic Google Scholar Andres Fernandez, 2Department Columbia University College...
epsilon-Aminocaproic acid (EACA) is an antifibrinolytic agent used to prevent rebleeding in aneurysmal subarachnoid hemorrhage. Although studies have found that a decrease with long-term therapy offset by increase ischemic deficits, more recent indicated early, short-term may be beneficial.We instituted protocol for acute EACA administration starting at diagnosis and continued maximum duration of 72 hours after hemorrhage onset. We compared 73 patients treated 175 non-EACA-treated patients....
This study compares 2 treatment protocols allowing low vs high continuous IV midazolam (cIV-MDZ) doses.We compared adults with refractory status epilepticus treated a protocol for high-dose cIV-MDZ (n = 100; 2002-2011) those the previous lower-dose 29; 1996-2000). We collected data on baseline characteristics, doses, seizure control, hospital course, and outcome.Median maximum dose was 0.4 mg/kg/h (interquartile range [IQR] 0.2, 1.0) group 0.2 (IQR 0.1, 0.3) low-dose (p < 0.001) similar...
<h3>Objective:</h3> To evaluate the sensitivity of quantitative EEG (QEEG) for electrographic seizure identification in intensive care unit (ICU). <h3>Methods:</h3> Six-hour epochs chosen from 15 patients underwent transformation into QEEG displays. Each epoch was reviewed 3 formats: raw EEG, + raw, and QEEG-only. Epochs were also analyzed by a proprietary detection algorithm. Nine neurophysiologists EEGs to identify seizures serve as gold standard. other with experience evaluated formats,...
Serious cardiac arrhythmias have been described in approximately 5% of patients after subarachnoid hemorrhage (SAH). The aim this study was to identify the frequency, risk factors and clinical impact arrhythmia SAH. We prospectively studied 580 spontaneous SAH identified complications associated with development clinically significant arrhythmia. Multiple logistic regression analysis used calculate adjusted odds ratios for effect on hospital 3-month outcome, as measured by modified Rankin...
To determine the impact of counter warming (CW) with an air circulating blanket on shivering and metabolic profile during therapeutic temperature modulation (TTM).A prospective observational study.An 18-bed neurologic intensive care unit.Fifty mechanically ventilated patients brain injury undergoing TTM automated surface intravascular devices.Fifty indirect calorimetry (IDC) measurements without CW TTM.IDC was continuously performed for 10-15 minutes at baseline (phase I), off II), again...
Object The purpose of this study was to identify predictors shunt-dependent hydrocephalus after aneurysmal subarachnoid hemorrhage (SAH). Methods authors evaluated the incidence in a consecutive cohort 580 patients with SAH who were admitted Neurological Intensive Care Unit Columbia University Medical Center between July 1996 and September 2002. Patient demographics, 24-hour admission variables, initial CT scan characteristics, daily transcranial Doppler development in-hospital complications...
Abstract Introduction Seizures refractory to third-line therapy are also labeled super-refractory status epilepticus (SRSE). These seizures extremely difficult control and associated with poor outcome. We aimed characterize efficacy side-effects of continuous infusions pentobarbital (cIV-PTB) treating SRSE. Methods retrospectively reviewed electroencephalography (cEEG) reports for all adults RSE treated cIV-PTB between May 1997 April 2010 at our institution. Patients post-anoxic SE those...
Importance Multiple continuous intravenous anesthetic drugs (CIVADs) are available for the treatment of refractory status epilepticus (RSE). There is a paucity data comparing different types CIVADs used RSE. Objective To systematically review and compare outcome measures associated with initial CIVAD choice in RSE accordance Preferred Reporting Items Systematic Reviews Meta-Analyses guidelines. Evidence Review Data sources included English non-English articles using Embase, MEDLINE, PubMed,...
Abstract The burden of epilepsy in the Latin America and Caribbean (LAC) region causes a profound regional impact on health care system significantly contributes to global burden. As many other resource-limited settings worldwide, professionals patients with LAC countries face challenges due combination factors, including high disease prevalence, stigmatization epilepsy, disparities access care, limited resources, substantial treatment gaps, insufficient training opportunities for providers,...
<h3>Objective</h3> Arterial hypertension (HTN) is a risk factor for subarachnoid haemorrhage (SAH). We aimed to assess the impact of premorbid HTN on severity initial bleeding and aneurysm rebleeding after SAH. <h3>Design</h3> Retrospective analysis prospective cohort study all SAH patients admitted Columbia University Medical Center between 1996 2012. <h3>Results</h3> enrolled 1312 consecutive with SAH; 643 (49%) had HTN. Patients presented more frequently as Hunt–Hess Grade IV or V (36% vs...
Hypertensive hypervolemic therapy is widely used to treat symptomatic vasospasm after subarachnoid hemorrhage. Few data exist support a relationship between early clinical response and mortality or functional outcome.In prospective cohort of 580 hemorrhage patients, we studied 95 patients with acute who received stepwise volume expansion crystalloid and/or 5% albumin solution followed by intravenous pressors maintain systolic blood pressure 180 220 mm Hg. We separately assessed the effects...