Category Archives: Neurology
New consensus guidelines do not recommend steroids for acute spinal cord injury, citing studies that they do more harm than good (including higher rates of infections, complications, ICU LOS, and death) (abstract).
This large cohort of patients age>65 who survived in-hospital cardiac arrest found that 1 year after discharge, 59% were still alive, and 34% had not been readmitted to the hospital. Both mortality and readmission rates were substantially affected by the … Continue reading
This single center retrospective cohort of patients presenting to an ED with acute dizziness found head CT imaging to be diagnostic in only 2% of patients; MRI yielded a diagnosis in 16% of patients. This study supports the recommendations of … Continue reading
This systematic review found quetiapine was more effective than placebo and as effective as haloperidol in reducing the duration of delirium, and is associated with fewer extrapyramidal side effects than the first generation antipsychotics. Quetiapine is a reasonable first line … Continue reading
This meta-analysis of critically ill patients found significantly worse outcomes in those that experience delirium compared to those that do not, including higher mortality, more complications, longer vent duration, and longer ICU and hospital LOS (abstract). Continued efforts for prevention … Continue reading
A brief outline of the AHA/ASA guidelines can be found here (synopsis).
In this randomized trial of patients with acute stroke s/p t-PA, they were randomized to further endovascular treatment or no treatment; the trial was stopped early, as the 90 day Rankin and NIHSS scores were no different between the groups, … Continue reading
The AHA/ASA has updated their guidelines for the management of acute stroke; they stress the need for early thrombolytics, early transfer to a stroke center or use of telemedicine consultation when feasible. The full guidelines are at (AHA/ASA)
This large meta-analysis of 52 trials found that SSRIs significantly reduced the risk of neurological deficit, dependence, disability, depression, and anxiety post stroke, compared to controls (abstract).
In this analysis from 2000-2009 from the Get with the Guidelines registry of patients with in-hospital cardiac arrest, 80% had asystole or PEA, and 20% Vfib/Vtach. Survival to discharge increased from 14% to 22% over the time period. Neurological disability … Continue reading