NASCET (North American Symptomatic CEA Trial) – CEA vs medical reduced risk of stroke (17%) and death (7%) at 2 years for stenosis >70%.
ACAS (Asymptomatic Carotid Artery Stenosis Trial) – CEA vs medical reduced risk of stroke or death (6%) at 5 years for stenosis >60%.
CREST (Carotid Revascularization Endarterectomy vs Stenting Trial) – CEA vs CAS in both symptomatic and asymptomatic – comparable rates of primary outcome measures (death, stroke, MI, stroke at 4 years). Periop stroke more in stenting, periop MI more in CEA. **NB Periopr stroke more disabling (based on 1 year in QOL assessment).
Experiences with carotid endarterectomy at Sree Chitra Tirunal Institute. Unnikrishnan M, Siddappa S, Anto R, Babu V, Paul B, Kapilamoorthy TR, Sivasankaran S, Sandhyamani S, Sreedhar R, Radhakrishnan K – Ann Indian Acad Neurol (2008)
Lee, Kiwon. The Neuroicu Book. 1st ed. Print.
“Initial Treatment Of Malignant Glioma In Older Adults”. Uptodate.com. 2017. Accessed 8 Mar. 2017.
Management of DCI is presented here as a three-stage algorithm. Tier One therapy should be initiated for new DCI which can manifest as neurological deterioration, characteristic imaging findings or MMM abnormalities indicating ischemia. Tier Two therapy hsould be started in cases of refractory DCI(inadequate reversal of ischemia after first-line therapy.)
Francoeur, Charles L. and Stephan A. Mayer. “Management Of Delayed Cerebral Ischemia After Subarachnoid Hemorrhage”. Critical Care 20.1 (2016).
Yaakov Friedman and Sabine Sobek. Critical Care Medicine: Principles of Diagnosis and Management in the Adult, 14, 202-212.e5. Tracheostomy.
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“Introduction To Imaging: What Am I Looking At?”. YouTube. N.p., 2016. Web. 19 Dec. 2016.
Na <133 mEq/L or a decrease of 6 mEq/L in 24 to 48 hours:
- NaCl tabs 3 g PO/NGT q6h
- Start 3%NaCl at 20 mL/h
- BMP q6h
Increase rate by 20 mL/h (max rate = 80 mL/h)
If on hold at present, initiate 3 percent NaCl infusion at 20 mL/h IV
Na = 130-135:
Increase rate by 10 mL/h (max rate = 80 mL/h)
If on hold at present, initiate 3 percent NaCl infusion at 10 mL/h IV
Na = 136-140:
Woo, Carolyn H. et al. “Performance Characteristics Of A Sliding-Scale Hypertonic Saline Infusion Protocol For The Treatment Of Acute Neurologic Hyponatremia”. Neurocritical Care 11.2 (2009): 228-234. Web.
Alonso de Leciñana, M. et al. “Endovascular Treatment In Acute Ischaemic Stroke. A Stroke Care Plan For The Region Of Madrid”. Neurología (English Edition) 28.7 (2013): 425-434.