Title Page -- Colophon -- Table of Contents -- Prologue -- Preface -- Section 1. Introduction to Neuroinjury -- 1 Neuroscience Critical Care: Two Experts' Point of View -- 1.1 History, Organization, and Vision for the Future: Prof. Mirski's Point of View -- 1.2 NICU Organization: Past, Present and Future: Prof. Robertson's Point of View -- References -- 2 Basic Anatomy Applied to the Interpretation of Axial Tomography of the Brain in Emergency Medicine -- 2.1 Introduction -- 2.2 Development -- 2.3 Key Concepts -- 2.4 Appendix: Images -- References -- General References -- 3 Physiological Basis for the Correct Interpretation of Different Situations in Acute Cerebral Injury -- 3.1 Functional and Structural Organization of the Nervous System -- 3.2 The Blood-Brain Barrier (BBB) -- 3.3 Cerebrospinal Fluid (CSF) -- 3.4 Aquaporins (AQP) -- 3.5 Intracranial Pressure -- 3.6 Cerebral Volume/Pressure Curve (V/P). Cerebral Compliance -- 3.7 Intracranial Pressure Curve -- 3.8 Cerebral Oxygen Metabolism -- 3.9 Cerebral Blood Flow (CBF) -- 3.10 Oxygen Tissue Pressure (ptiO2) -- 3.11 Cerebral Glucose Metabolism -- 3.12 Cerebral Temperature -- 3.13 Brain-systemic Temperature Gradient -- 3.14 Concept of Primary and Secondary Injury -- General References -- 4 Examination of the Critically Ill Neurological Patient -- 4.1 Clinical Evaluation (or Examination) of the Critically Ill Neurological Patient -- 4.2 General Examination -- 4.3 Comprehensive Neurological Examination -- 4.4 Routine Investigations of the Neurocritical Patient -- 4.5 Focused Neurological Examination of Selected Topics -- References -- General References -- 5 Evaluation Scales in Neurocritically Ill Patients -- 5.1 Objectives -- 5.2 Introduction -- 5.3 Evaluation in the Acute Phase -- 5.4 Imaging-based Assessment Scales.

5.5 Scale of Evolution, Evaluation of Consciousness in Advanced Stages of Brain Injury Outcome Scales -- General References -- Section 2. Neuromonitoring -- 6 Neuroimage Monitoring in the Management of Neurocritical Care Patients -- 6.1 Introduction -- 6.2 CT in Head-injured Patients -- 6.3 CT in Patients With Cerebrovascular Hemorrhagic Disease -- 6.4 CT in the Diagnosis of Acute Ischemic Cerebrovascular Diseases -- 6.5 Conclusions -- References -- 7 Intracranial Pressure Monitoring. Acute Cerebral Injury: the First 48 Hours -- 7.1 Intracranial Pressure -- 7.2 Techniques for Monitoring Intracranial Pressure -- 7.3 The ICP Waveform -- 7.4 Elevated Intracranial Pressure and Pressure Waves -- 7.5 Cerebral Perfusion Pressure -- 7.6 Cerebral Autoregulation -- 7.7 Indications for ICP Monitoring -- 7.8 Conclusions -- References -- 8 Update on Brain Tissue Oxygen Monitoring in TBI and Other Acute Cerebral Disorders -- 8.1 Introduction -- 8.2 Approaches to Monitoring Cerebral Oxygenation -- 8.3 Hyperemia and Arterial pCO2 -- 8.4 Approaches to Treatment -- 8.5 Early Detection and Treatment of Ischemia -- 8.6 Suggestions and Limitations -- 8.7 Conclusions -- References -- 9 Monitoring Cerebral Blood Flow and Cerebral Autoregulation: Basic Principles, Techniques, Common Patterns and Interpretation of Results -- 9.1 Introduction -- 9.2 Physiology of Cerebral Circulation -- 9.3 Techniques to Measure Cerebral Blood Flow -- 9.4 CBF in Pathological Conditions -- 9.5 Key Concepts -- References -- 10 The Current Role of Transcranial Doppler in the Intensive Care Unit. Indications, Bases for Its Correct Interpretation, Most Frequent Applications and Patterns -- 10.1 CBF Monitoring at the Bedside. Transcranial Doppler Ultrasound -- 10.2 Flow Velocity and Pulsatility Index. Normal Range and its Variations.

10.3 Clinical Applications of Transcranial Doppler in Intensive Care Medicine -- 10.4 Transcranial Ultrasonographic Abnormalities in Neurocritical Patients -- 10.5 Extreme Expression of Intracranial Hypertension: Cerebral Circulatory Arrest -- 10.6 TCD as a Complementary (Auxiliary) Diagnostic Technique in Determining Brain Death -- 10.7 Summary of Changes in Cerebral Hemodynamics: Muñoz Chard -- 10.8 Assessment of Cerebrovascular Reactivity -- 10.9 Appendix -- 10.10 TCD in Evaluating Hemodynamics -- 10.11 Relationship Between CBF and CPP -- References -- 11 Neurophysiologic Monitoring in Neurointensive Care: EEG, EMG, and Evoked Potentials -- 11.1 Introduction -- 11.2 Electroencephalography -- 11.3 Evoked Potential -- 11.4 Continuous Neurophysiological Monitoring (EEG-SEP) in the ICU -- 11.5 EMG in the ICU -- References -- 12 Monitoring Brain Chemistry by Microdialysis During Neurointensive Care -- 12.1 Introduction -- 12.2 The Microdialysis Technique -- 12.3 Biochemical Markers of Ischemia and Cell Damage -- 12.4 Lactate/Pyruvate Ratio -- 12.5 Glycerol -- 12.6 Glutamate -- 12.7 Glucose -- 12.8 Implanting and Positioning of Microdialysis Catheters -- 12.9 Selecting Perfusion Flow -- 12.10 Multimodal Monitoring -- 12.11 Interpreting Microdialysis Data -- 12.12 Clinical Studies -- 12.13 Conclusions -- References -- Section 3. General Support -- 13 Fluid Therapy in Acute Brain Injury -- 13.1 Introduction -- 13.2 Fluids Commonly Used in Neurocritical Care -- 13.3 Use of Fluids in Neurocritical Care -- 13.4 Conclusions -- References -- 14 The Metabolism of Sodium and Its Effect on the Brain -- 14.1 Introduction -- 14.2 Hyponatremia -- 14.3 Hypernatremia -- 14.4 Clinical Management and Treatment -- General References -- 15 Hemodynamic Monitoring -- 15.1 Introduction -- 15.2 Indications and Complexity of Hemodynamic Monitoring.

15.3 Definitions and Hemodynamic Parameters -- 15.4 Pressure Monitoring -- 15.5 Pulmonary Artery Pressure and the Swan-Ganz Catheter -- References -- 16 Cardiac Arrhythmias in Nervous System Disorders -- 16.1 Introduction -- 16.2 Stroke -- 16.3 Paroxysmal Essential Hyper- and Hypopothassemia (Periodic Paralysis) -- 16.4 Dystrophy -- 16.5 Myotonic Muscular Dystrophy -- 16.6 Steinert Myotonic Dystrophy -- 16.7 Emery-Dreyfuss Muscular Dystrophy -- 16.8 Muscular Dystrophy of the Extremities and the Waist -- 16.9 Friederich's Ataxia -- 16.10 Kearns-Sayre Syndrome -- 16.11 Leber's Hereditary Optical Neuropathy -- 16.12 Guillain-Barré Syndrome -- 16.13 Myasthenia Gravis -- 16.14 Epilepsy -- General References -- 17 Mechanical Ventilation in the Neurologic Critically Ill Patient -- 17.1 Introduction -- 17.2 Breathing Control and Respiratory Depression -- 17.3 Sedation -- 17.4 Hyperventilation -- 17.5 Lung Recruitability and Use of PEEP -- 17.6 ALI/ARDS and Ventilator-induced Lung Injury -- 17.7 Weaning -- 17.8 Tracheostomy -- 17.9 Conclusions -- General References -- 18 Surgical Airway Management in the Neurocritically Ill Patient: Timing, Technique, and Complications -- 18.1 Introduction -- 18.2 Surgical Airway Management -- 18.3 Conclusions -- References -- 19 Gastrointestinal Disorders in the Neurocritical Patient -- 19.1 Gastrointestinal Motility Disorders in the Neurocritical Patient -- 19.2 Common Gastroenterological Disorders in Severe Acute Neurological Illness -- General References -- 20 Nutritional Support in Critically Ill Patients -- 20.1 Introduction -- 20.2 Metabolism During Injury -- 20.3 Assessment of Nutritional Status -- 20.4 Anthropometric Measurement -- 20.5 Biochemical Measures (Biological Indicators) -- 20.6 Nutritional Requirements -- 20.7 Artificial Nutrition -- 20.8 Enteral Nutrition -- 20.9 Parenteral Nutrition.

20.10 Assessment and Monitoring of Artificial Nutrition -- 20.11 Is There a Specific Nutritional Formulation for Patients with Brain Injury? -- General References -- 21 Acute Renal Injury in the Neurocritical Patient -- 21.1 Introduction -- 21.2 Epidemiology of Acute Kidney Injury -- 21.3 Definition of AKI in Critically Ill Patients -- 21.4 Diagnosis of AKI in Critically Ill Patients -- 21.5 Common Causes of AKI in Critically Ill Patients -- 21.6 Prevention and Management of AKI in Critically Ill Patients -- 21.7 Indications and Initiation of Renal Replacement Therapy in AKI -- 21.8 Dose of Renal Replacement Therapy in Acute Kidney Injury -- 21.9 Methods of Renal Replacement Therapy in Acute Kidney Injury -- 21.10 Conclusions -- General References -- 22 The Brain and the Abdomen: Closer Than You Think -- 22.1 Introduction -- 22.2 The Relationship Between IAP and ICP -- 22.3 Clinical Importance of IAH in Patients at Risk for ICH -- 22.4 Treatment Options -- 22.5 Clinical Recommendations -- 22.6 Conclusions -- References -- 23 Endocrinology of Acute Brain Injury -- 23.1 Basic Anatomy, Physiology and Changes in Acute Brain Injuries -- 23.2 Endocrinology of Acute Brain Injury Secondary to Traumatic Brain Injury (TBI) and Subarachnoid Hemorrhage (SAH) -- General References -- 24 Coagulation Disorders in the Neurocritical Patient -- 24.1 Introduction -- 24.2 Pathophysiology -- 24.3 Traumatic Brain Injury -- 24.4 Spontaneous Intracranial Hemorrhage -- 24.5 Ischemic Stroke -- 24.6 Subarachnoid Hemorrhage -- 24.7 Prophylaxis of Pulmonary Thromboembolism in Neurocritical Patients -- General References -- Section 4. Intracranial Hypertension -- 25 Pathophysiology of Intracranial Hypertension -- 25.1 General Concepts -- 25.2 Compliance -- 25.3 ICP Waves -- 25.4 Factors Which the ICP Depends on -- 25.5 Intracranial Hypertension Compensating Mechanisms.

25.6 Effects of Intracranial Hypertension.