Neurocritical Care for Neurosurgeons: Principles and Applications

732 Pages·2021·16.233 MB·English

by  Eberval Gadelha Figueiredo, Leonardo C. Welling, Nícollas Nunes Rabelo

Neurocritical Care
for Neurosurgeons
Principles and Applications
Eberval Gadelha Figueiredo
Leonardo C. Welling
Nícollas Nunes Rabelo
Editors
123
Neurocritical Care for Neurosurgeons
Eberval Gadelha Figueiredo
Leonardo C. Welling • Nícollas Nunes Rabelo
Editors
Neurocritical Care
for Neurosurgeons
Principles and Applications
Editors
Eberval Gadelha Figueiredo Leonardo C. Welling
University of São Paulo State University of Ponta Grossa
São Paulo Ponta Grossa
Brazil Paraná
Brazil
Nícollas Nunes Rabelo
University of São Paulo
São Paulo
Brazil
ISBN 978-3-030-66571-5 ISBN 978-3-030-66572-2 (eBook)
https://doi.org/10.1007/978-3-030-66572-2
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Foreword
As every neurosurgeon is aware, our surgical results depend on so much more than
just excellent technical competency. Of the many requirements for getting the best
outcomes for our patients like appropriate decision-making, great neuroanesthesia,
and good staff, none are more pertinent than excellent neurocritical management.
Drs. Eberval Gadelha Figueiredo, Leonardo C. Welling, and Nícollas Nunes
Rabelo have collected superb experts and assembled a long-overdue book on the
practical aspects of achieving outstanding critical care.
It is divided into four parts — the first presents and details the general basic prin-
ciples of neurosurgical care, including monitoring and interpretation of exams. In
the second part, the authors present and thoroughly discuss general management of
neurocritical patients. Specific conditions and diseases care are discussed in Part
III. In Part IV, outcomes and strategies of rehabilitation are presented.
This volume is appropriate for all those involved in the care of neurosurgical
patients, especially residents, critical care physicians, neurologists, and all
neurosurgeons.
I congratulate the authors for the excellent job in presenting this much-needed
material and suspect it will be used routinely by physicians taking care of these
critical patients.
Robert F. Spetzler
Department of Neurosurgery
Barrow Neurological Institute
Phoenix, AZ, USA
v
Acknowledgments
To think is easy. To act is hard. But the hardest thing in the world is to act in accordance with
your thinking. Johann Wolfgang von Goethe
No new project comes about without the tough efforts of a number of colleagues,
and this book is certainly no exception. We would like to start by thanking the edito-
rial and production teams at Springer Nature, as always, an extremely talented and
most pleasant group to work with. It is clearly through their efforts that the pub-
lished result is so outstanding. Second, we would like to thank all authors and col-
laborators that persisted highly committed even in the adversity and uncommon
occurrence of the COVID-19 pandemic that changed everyone’s life. For a few
moments, it seemed impossible to get all the pieces together and their individual
contributions, which included skilled editing, production, and design. It shows that
even in the face of the impossible dream, it is possible to accomplish great things.
A special thanks to our families, parents, wives, sons, and friends that in hard
moments who understood us in difficult times, and always believed and supported
the project. For friends and other collaborators who, even in anonymity, were
unconditionally supportive.
This book is about Neurocritical Care for Neurosurgeons: Principles and
Applications, a fundamental part of our routine of patient care. It is well known that
the details in the neurocritical care of patients make a total difference in outcome,
no matter how beautifully one operates. This book is for medical students, residents,
fellows, faculty, neurosurgeons, neurologists, and general physicians who cope with
these challenging conditions on a daily basis.
Finally, we would like to acknowledge all our teachers, mentors, and others who
inspired us all these years for their guidance, encouragement, and friendship.
Eberval Gadelha Figueiredo
Professor of Neurosurgery – University of São Paulo, Brazil
Leonardo C. Welling
Neurological Surgery Department – State University of Ponta Grossa, Brazil
Nícollas Nunes Rabelo
Neurological Surgery Department – University of São Paulo, Brazil
vii
Contents
1 Neurocritical Care: An Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Nícollas Nunes Rabelo, Leonardo C. Welling,
and Eberval Gadelha Figueiredo
Part I The Basics and Monitoring
2 Metabolism and Cerebral Blood Flow . . . . . . . . . . . . . . . . . . . . . . . . . 17
Markus Dengl and Gabriele Schackert
3 Brain Edema: Pathophysiology, Diagnosis, and Treatment . . . . . . . . 27
Jesse A. Stokum, Phelan Shea, Gary Schwartzbauer,
and J. Marc Simard
4 Intracranial Pressure: Invasive Methods of Monitoring . . . . . . . . . . . 45
Ruy Castro Monteiro da Silva Filho
and Paulo Eduardo de Mello Santa Maria
5 Noninvasive Intracranial Pressure Monitoring . . . . . . . . . . . . . . . . . . 57
Leonardo C. Welling, Gustavo Frigieri, Nícollas Nunes Rabelo,
and Eberval Gadelha Figueiredo
6 Brain Tissue Oxygen Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
Fábio Santana Machado, Leonardo C. Welling,
Nícollas Nunes Rabelo, and Eberval Gadelha Figueiredo
7 Brain Microdialysis Monitoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
Maria A. Poca, David Sanchez-Ortiz, Jacinto Baena,
and Juan Sahuquillo
8 Jugular Bulb Oximetry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113
Leonardo C. Welling, Nícollas Nunes Rabelo,
and Eberval Gadelha Figueiredo
ix
x Contents
9 Transcranial Doppler: Practical Applications . . . . . . . . . . . . . . . . . . . 129
Ricardo de Carvalho Nogueira, Rafaela Almeida Alquéres,
Victor Marinho Silva, and Pamela Torquato de Aquino
10 Electroencephalogram in the Neurosurgical Intensive
Care Unit (When a Single EEG Is Not Enough) . . . . . . . . . . . . . . . . . 147
Luiz H. Castro
11 Radiological Evaluation of Postoperative Complications
of Intracranial Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165
Fabricio Stewan Feltrin, Eduarda Tavares da Rocha de Azeredo Bastos,
and Mariana Dalaqua
Part II G eneral Management
12 Management of Intracranial Hypertension . . . . . . . . . . . . . . . . . . . . . 193
Estêvão Bassi, Bruno Martins Tomazini, Filipe Mateus Cadamuro,
Roberta Muriel Longo Roepke, Bárbara Vieira Carneiro,
and Luiz Marcelo Sá Malbouisson
13 Neuroprotection in Brain Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211
Nícollas Nunes Rabelo, Leonardo C. Welling,
Robson Luis Oliveira de Amorim, and Eberval Gadelha Figueiredo
14 Decompressive Craniectomy: Breaking Skepticism . . . . . . . . . . . . . . 221
Leonardo C. Welling, Nícollas Nunes Rabelo,
and Eberval Gadelha Figueiredo
15 Sedation and Analgesia in Neurocritical Patients . . . . . . . . . . . . . . . . 241
Manoel Jacobsen Teixeira, Daniel Ciampi de Andrade,
Wellingson da Silva Paiva, Leonardo C. Welling,
Nícollas Nunes Rabelo, and Eberval Gadelha Figueiredo
16 Hemodynamic Management in the Neurocritical Patient . . . . . . . . . . 301
Sâmia Yasin Wayhs and Edwin Koterba
17 Blood Transfusion Strategies in Neurocritical Care . . . . . . . . . . . . . . 323
André Luiz Nunes Gobatto, Marcela de Almeida Lopes,
and Luiz Marcelo Sá Malbouisson
18 Ventilatory Strategies in the Neurocritical Care . . . . . . . . . . . . . . . . . 337
Salomón Soriano Ordinola Rojas, Amanda Ayako Minimura Ordinola,
João Paulo Mota Telles, Leonardo C. Welling, Nícollas Nunes Rabelo,
and Eberval Gadelha Figueiredo
19 Endotracheal Intubation, Extubation, and Tracheostomy:
How, When, and Why? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 347
Leonardo C. Welling, Nícollas Nunes Rabelo,
and Eberval Gadelha Figueiredo
Contents xi
20 Infections in Neurocritical Care Units . . . . . . . . . . . . . . . . . . . . . . . . . 359
Alok Patel, Ivan da Silva, and Andre Beer-Furlan
21 Acid-Base and Electrolyte Disorders in Neurocritical Care . . . . . . . . 373
Renata Harumi Gobbato Yamashita, Vitor Nagai Yamaki,
Nícollas Nunes Rabelo, Leonardo C. Welling,
and Eberval Gadelha Figueiredo
22 Basic Aspects of Nutrition in Neurocritical Care . . . . . . . . . . . . . . . . . 391
Vitor Nagai Yamaki, Nícollas Nunes Rabelo, Leonardo C. Welling,
and Eberval Gadelha Figueiredo
23 General Principles of Neurosurgical Postoperative Care . . . . . . . . . . 407
Manoel Jacobsen Teixeira, Davi J. Fontoura Solla,
and Wellingson S. Paiva
24 Head Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 431
Prashin Unadkat, Katherine Wagner, and Jamie S. Ullman
25 Spontaneous Subarachnoid Hemorrhage and the First
Week After Aneurysmal Subarachnoid Hemorrhage . . . . . . . . . . . . . 449
Brenna Kathleen McElenney, Craig Schreiber, Joseph Georges,
and Peter Nakaji
26 Hemorrhagic Stroke . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 483
Joao Brainer Clares de Andrade, Felipe Chaves Duarte Barros,
and Gisele Sampaio Silva
27 Cerebral Hemorrhage and High INR . . . . . . . . . . . . . . . . . . . . . . . . . . 501
Gustavo Cartaxo Patriota and Rui Paulo Vicente Reinas
28 Ischemic Stroke . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 517
Mateus P. Pellegrino, Felipe Moreira, and Adriana B. Conforto
29 Emergencies in Neuro-oncology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 535
José Marcus Rotta, Afonso Henrique Dutra de Melo,
and Rodolfo Casimiro Reis
30 Hemorrhage into a Pituitary Tumor . . . . . . . . . . . . . . . . . . . . . . . . . . . 555
Christiane Fialho Gonsalves, Leandro Kasuki,
and Mônica Gadelha
31 Status Epilepticus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 565
Christiane Cobas and Eliana Garzon
32 Systemic (Non-neurological) Complications
in the Neurocritical Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 579
Salomón Soriano Ordinola Rojas, Amanda Ayako Minimura
Ordinola, Leonardo C. Welling, Nícollas Nunes Rabelo,
João Paulo Mota Telles, and Eberval Gadelha Figueiredo
xii Contents
33 Acute Spinal Cord Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 599
Erion Junior de Andrade, Fernando Luís Maeda,
Raphael Augusto Correa Bastianon Santiago,
and Andrei Fernandes Joaquim
34 General Principles of Awake Neurosurgery . . . . . . . . . . . . . . . . . . . . . 619
Eduardo Carvalhal Ribas, Cristiana Pinheiro Protasio,
Sang Ken Kim, Hannah Keeble, and Christian Brogna
35 TBI in Pediatric Patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 635
Giselle Coelho and Eduardo Varjão Vieira
Part III The Outcomes
36 Prognostic Models in Neurocritical Care . . . . . . . . . . . . . . . . . . . . . . . 649
Leonardo C. Welling, Nícollas Nunes Rabelo,
Jefferson Rosi Junior, and Eberval Gadelha Figueiredo
37 Rehabilitation and Palliative Care in Neurocritical Patients . . . . . . . 667
Rebeca Boltes Cecatto and Linamara Rizzo Battistella
38 Brain Death and Management of the Potential Donor . . . . . . . . . . . . 677
Leonardo C. Welling, Thomas Markus Dhaese,
Nícollas Nunes Rabelo, and Eberval Gadelha Figueiredo
39 New Perspectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 697
Leonardo C. Welling, Nícollas Nunes Rabelo,
and Eberval Gadelha Figueiredo
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 721