Blood pressure management in ischemic stroke patients undergoing mechanical thrombectomy.

The relationship between presenting blood pressure in acute ischemic stroke patients and outcome is complex. Several studies have demonstrated a U-shaped curve with worse outcomes when blood pressure is high or low. The American Heart Association/American Stroke Association guidelines recommend values of blood pressure < 185/110 mmHg in patients treated with intravenous t-PA and "permissive hypertension" up to 220/120 mmHg in those not treated with intravenous t-PA.

Big data and predictive analytics in neurocritical care.

Purpose Of Review: To describe predictive data and workflow in the intensive care unit when managing neurologically ill patients.

Recent Findings: In the era of Big Data in medicine, intensive critical care units are data-rich environments. Neurocritical care adds another layer of data with advanced multimodal monitoring to prevent secondary brain injury from ischemia, tissue hypoxia, and a cascade of ongoing metabolic events.

Poor drug adherence and lack of awareness of hypertension among hypertensive stroke patients in Kampala, Uganda: a cross sectional study.

Background: Raised blood pressure (BP) remains an important risk factor for cardiovascular diseases such as stroke. Adherence to therapeutic recommendations especially antihypertensive drugs is important in BP control. The aim of the study was to assess the stroke risk factors and levels of adherence among hypertensive patients with stroke in Kampala Uganda.

Brain Tissue Oxygen Monitoring in Neurocritical Care.

Brain injury results from ischemia, tissue hypoxia, and a cascade of secondary events. The cornerstone of neurocritical care management is optimization and maintenance of cerebral blood flow (CBF) and oxygen and substrate delivery to prevent or attenuate this secondary damage. New techniques for monitoring brain tissue oxygen tension (PtiO2) are now available.

Prognosis of coma after cardiac arrest in the era of hypothermia.

Purpose Of Review: Outcome prediction is more difficult in comatose survivors of cardiac arrest who are treated with hypothermia than in those who are kept normothermic. This article compares prognostication measures in these two groups of patients.

Recent Findings: The introduction of therapeutic hypothermia for cardiac arrest has resulted in reduced mortality and better neurologic outcomes among survivors.

Critical care management in acute ischemic stroke.

Neurocritical care has evolved over the past 20 years in parallel with the growth of critical care medicine and the stunning developments in the fields of neurology and neurosurgery. Although clinical trials are needed, there is preliminary evidence that induced hypertension and hypothermia can improve outcomes. The optimal threshold for transfusion of red cells remains unknown in patients with ischemic stroke and similarly further studies are needed to examine glycemic control and identify which patients may benefit most from aggressive insulin therapy.