Publications by authors named "Christopher Commichau"
Background: Posterior reversible encephalopathy syndrome (PRES) is a clinical-radiographic syndrome formally recognized in 1996, which describes specific changes noted on neuroimaging thought to be related to impaired cerebral blood flow autoregulation and endothelial dysfunction. We report a case of PRES in the setting of increased ingestion of ondansetron; complicated by hemorrhagic transformation and refractory intracranial hypertension. We hypothesize an association of 5-HT3 antagonism and PRES.
View Article and Find Full Text PDFBackground: There is considerable debate regarding the appropriateness of feeding patients by the enteral route in conjunction with pentobarbital coma therapy.
Objective: To determine the incidence of feeding intolerance (FI) in patients receiving pentobarbital in conjunction with enteral nutrition (EN).
Methods: A retrospective, observational evaluation of patients (>14 y of age) who received a therapeutic pentobarbital coma in combination with EN was conducted.
Objective: There are few data regarding anemia and transfusion after subarachnoid hemorrhage (SAH). We addressed the hypothesis that higher hemoglobin (HGB) levels are associated with less death and disability after SAH.
Design: Prospective registry with automated data retrieval.
Background: Cardiac troponin I (cTI) release occurs frequently after subarachnoid hemorrhage (SAH) and has been associated with a neurogenic form of myocardial injury. The prognostic significance and clinical impact of these elevations remain poorly defined.
Methods And Results: We studied 253 SAH patients who underwent serial cTI measurements for clinical or ECG signs of potential cardiac injury.
Background: Aneurysm rebleeding has historically been an important cause of mortality after subarachnoid hemorrhage (SAH).
Objective: To describe the frequency and impact of rebleeding in the modern era of aneurysm care, which emphasizes early surgical or endovascular treatment.
Design: Inception cohort.
Objective: Hydroxymethylglutaryl coenzyme A reductase inhibitors (statins), which exhibit beneficial cerebrovascular effects by modulating inflammation and nitric oxide production, have not been evaluated in acute aneurysmal subarachnoid hemorrhage (SAH) patients. The effect of prior statin use on 14-day functional outcome and on prevention of vasospasm-induced delayed cerebral ischemia (DCI) or stroke during hospitalization was analyzed.
Methods: We conducted a 1:2 matched (age, admission Hunt and Hess grade, vascular disease/risk history) cohort study of 20 SAH patients on statins and 40 SAH controls.
Background And Purpose: Phenytoin (PHT) is routinely used for seizure prophylaxis after subarachnoid hemorrhage (SAH), but may adversely affect neurologic and cognitive recovery.
Methods: We studied 527 SAH patients and calculated a "PHT burden" for each by multiplying the average serum level of PHT by the time in days between the first and last measurements, up to a maximum of 14 days from ictus. Functional outcome at 14 days and 3 months was measured with the modified Rankin scale, with poor functional outcome defined as dependence or worse (modified Rankin Scale > or =4).
Objective: Neurogenic stunned myocardium is a well-recognized complication of subarachnoid hemorrhage. Dobutamine and milrinone are both used for neurogenic stunned myocardium, but there are few data comparing them after subarachnoid hemorrhage.
Methods: We compared the physiological dose response of dobutamine and milrinone in patients with subarachnoid hemorrhage requiring a pulmonary artery catheter.
Objective: To compare the efficacy of a novel water-circulating surface cooling system with conventional measures for treating fever in neuro-intensive care unit patients.
Design: Prospective, unblinded, randomized controlled trial.
Setting: Neurologic intensive care unit in an urban teaching hospital.
Objective: To identify risk factors for fever among patients treated in a neurologic intensive care unit (NICU).
Methods: The authors prospectively studied the frequency and causes of fever, defined as a patient's first temperature > or =101 degrees F (38.3 degrees C), among 387 patients consecutively admitted to their NICU.