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Admission to neurological intensive care: Who, when, and why?

Howard, RS; Kullmann, DM; Hirsch, NP; (2003) Admission to neurological intensive care: Who, when, and why? J NEUROL NEUROSUR PS , 74 III2 - III9.

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Abstract

The majority of neurologists work in district general or teaching hospitals with large general intensive care units (ICUs). In this setting, ICUs require an increasing input from neurologists, especially with regard to the assessment of hypoxic brain damage and the neurological complications of organ failure, critical illness, and sepsis. In contrast, dedicated neurological intensive care units (NICUs) tend to deal largely with a different population of patients. Such units are primarily concerned with the management of primary encephalopathic patients, the control of raised intracranial pressure (ICP), the management of ventilatory, autonomic, and bulbar insufficiency, and the consequences of profound neuromuscular weakness. This role encompasses the treatment of mechanical ventilatory failure, specific treatments (both medical and surgical) and general medical complications of these disorders.(1)In general, NICU patients with primary neurological diseases such as myasthenia gravis, Guillain-Barre syndrome, central nervous system infections, status epilepticus, and stroke have a better outcome than those patients with secondary neurological disease seen on general ICUs. However, such patients remain dependent on ICU support for very much longer periods of time. This results in very significant psychological demands on the patients, their carers, the nurses, physicians, and other health care professionals. In this review we will consider the rationale for managing acute neurological conditions in a dedicated NICU environment.

Type: Article
Title: Admission to neurological intensive care: Who, when, and why?
Keywords: GUILLAIN-BARRE-SYNDROME, STATUS EPILEPTICUS, MECHANICAL VENTILATION, VIRAL ENCEPHALITIS, MULTIPLE-SCLEROSIS, MANAGEMENT, ENCEPHALOMYELITIS, HEMORRHAGE, DIAGNOSIS, STROKE
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Clinical and Experimental Epilepsy
URI: http://discovery.ucl.ac.uk/id/eprint/70414
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