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Neurological Critical Care

Neurological emergencies have a high rate of morbidity and mortality. Prompt intervention reduces permanent damage to the nervous system and save the lives of patients. The neurological critical care unit aims to stabilize the patients' neurological health as early as possible. Various advanced equipment are available for critical neurological care that assists doctors in diagnosing and managing emergency conditions.

"Critical Care Medicine"

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Diseases and conditions

  • Brain Stroke: It is a medical emergency characterized by a reduced or complete blockage of blood flow to the brain. It is of two types, i.e., ischemic stroke and hemorrhagic stroke.
  • Neuromuscular disorders: The nervous system controls the functioning of muscles in the body. Patients with neuromuscular disorders experience muscular dysfunction due to the disease of the nerves. A common symptom of neuromuscular disorders is muscle weakness.
  • Seizures: A seizure occurs when there is excessive and uncontrolled electrical activity in the brain. Patients with seizures have alterations in their movements, feelings, or behavior. The level of consciousness is also changed during a seizure attack.
  • Nervous system infections: Nervous system infections require unique treatment strategies due to inherent difficulties, such as the high risk of complications, the blood-brain barrier, and the high rate of mortality. The infections generally include encephalitis, meningitis, and brain abscesses
  • Head Injuries: Head injuries include scalp, skull, or brain injuries. The complexity of head injuries may range from a mild bruise to a more severe traumatic brain injury. The causes of head injuries include physical assaults, vehicle accidents, falls, and sports-related accidents.
  • Neurological Post-Operative care: Post-operative care after a neurological surgery is of vital importance to improve the outcomes of the surgery. Neurosurgical post-operative care includes airway management, fluid management, nutrition, analgesia, hemodynamics maintenance, and disease-related complications prevention.

Procedures and treatment

  • Thrombolysis: Thrombolysis is the process of dissolving the clots and preventing the formation of new clots through medications. Intravenous thrombolysis is an effective treatment in the management of acute ischemic stroke.
  • Cerebral Protection: Cerebral protection involves preventing damage to neuronal tissues. Damage to these tissues results in loss of consciousness, speech, emotional integrity, and intellectual capacity. Strategies for cerebral protection depend upon the pathophysiological processes damaging the brain.
  • Coma Management: The treatment of a coma depends upon the underlying cause. In cases of brain swelling, the doctor may relieve the pressure on the brain.The patients may also receive antibiotics and glucose through the intravenous route. Emergency centers may also offer breathing assistance and supportive therapy.
  • Continuous EEG: Continuous EEG is a method to continuously determine brain activity. It constantly assesses the cerebral cortical activity in critically ill, comatose patients.
  • Management of CNS Infections: Management of bacterial and fungal infections includes antibiotics for infection, intravenous fluids for fluid management and nutrition, steroids for swelling in the brain, and anticonvulsants for seizures. Many viral infections of the nervous system resolve without any treatment; however, the patients may require supportive therapy.

Faq's

Neurological Critical Care involves specialized medical care for patients with severe neurological conditions that require intensive monitoring and treatment. It aims to provide comprehensive management for individuals with acute brain injuries or critical neurologic illnesses.

A brain stroke occurs when the blood supply to the brain is disrupted, leading to damage or death of brain cells. It can result in various symptoms like sudden weakness or numbness in one side of the body, difficulty speaking, loss of balance, and vision problems.

Thrombolysis is a time-sensitive treatment option used for ischemic strokes caused by a blood clot blocking an artery supplying the brain. This procedure involves administering medication intravenously to dissolve the clot and restore blood flow quickly.

Thrombolysis can significantly improve outcomes after an ischemic stroke if administered promptly within the recommended time window. By restoring blood flow to deprived areas of the brain quickly, it may help minimize long-term disability and maximize chances of recovery.

Continuous EEG (Electroencephalography) monitoring provides real-time assessment of electrical activity in the brain's neurons over an extended period. This technology helps identify abnormal patterns indicative of seizures or other neurologic disorders and guides appropriate interventions.

Continuous EEG allows healthcare professionals to monitor changes in brain activity continuously while managing critically ill patients with neurological conditions such as seizures or altered mental status.

It assists clinicians in detecting seizure activity promptly, evaluating response to treatment, and adjusting medication dosages accordingly.

Continuous EEG monitoring is a non-invasive procedure that involves placing electrodes on the scalp using adhesive patches or a cap-like device. It does not cause any pain and is generally well tolerated by patients.

Both ischemic and haemorrhagic strokes reduce or block the blood supply to a specific brain area. Ischemic stroke is the blockage of blood vessels supplying blood to the tissues. Haemorrhagic stroke involves rupturing and bleeding of blood vessels.