Publications by authors named "J C Ader"
The subspecialty of neurocritical care has grown significantly over the past 40 years along with advancements in the medical and surgical management of neurological emergencies. The modern neuroscience intensive care unit (neuro-ICU) is grounded in close collaboration between neurointensivists and neurosurgeons in the management of patients with such conditions as ischemic stroke, aneurysmal subarachnoid hemorrhage, intracerebral hemorrhage, subdural hematomas, and traumatic brain injury. Neuro-ICUs are also capable of specialized monitoring such as serial neurological examinations by trained neuro-ICU nurses; invasive monitoring of intracranial pressure, cerebral oxygenation, and cerebral hemodynamics; cerebral microdialysis; and noninvasive monitoring, including the use of pupillometry, ultrasound monitoring of optic nerve sheath diameters, transcranial Doppler ultrasonography, near-infrared spectroscopy, and continuous electroencephalography.
View Article and Find Full Text PDFRecovery of consciousness after acute brain injury: a narrative review.
J Intensive Care
September 2024
Background: Disorders of consciousness (DoC) are frequently encountered in both, acute and chronic brain injuries. In many countries, early withdrawal of life-sustaining treatments is common practice for these patients even though the accuracy of predicting recovery is debated and delayed recovery can be seen. In this review, we will discuss theoretical concepts of consciousness and pathophysiology, explore effective strategies for management, and discuss the accurate prediction of long-term clinical outcomes.
View Article and Find Full Text PDFArticle Synopsis
- Delays in hospital presentation for stroke patients were linked not only to individual factors but also to broader community-level social vulnerabilities, indicating a need for better support in these areas.
- The study analyzed over 149,000 ischemic stroke patients and found that those in socially vulnerable neighborhoods took longer to arrive at hospitals, with an average delay of about 15.6 minutes compared to those from less vulnerable areas.
- Mapping these delays revealed overlapping zones of delay and vulnerability, highlighting the impact of socioeconomic conditions and community resources on timely medical care.
Article Synopsis
- The study investigates the long-term outcomes of comatose patients with brain injuries in Japan, focusing on those anticipated to make no meaningful recovery.
- Out of 860 screened patients, 40 were evaluated, revealing a diverse range of functional outcomes after 6 months, despite initial predictions.
- Results showed that while many patients were dead or in long-term care, a few displayed some ability to follow commands, challenging assumptions about recovery potential.