Emergenze e urgenze

Neurocritical care as a subspecialty has grown rapidly over the last 20 years with the advent of newer monitoring and diagnostic techniques and therapeutic modalities in a variety of brain and spinal cord injury paradigms. This handbook will serve as a quick reference guide to all health care providers in a neurocritical care setting. Since time is of the essence in the rapid diagnosis and timely therapeutic interventions for these patients, this book provides an algorithmic approach to making a clinical diagnosis using ancillary investigations to confirm the diagnosis and provide appropriate management of acute neurologic diseases. Tables and illustrations help provide a quick and easy bedside reference and give a practical approach to the management of these patients.

An authoritative and comprehensive review of the most important clinical issues facing critically ill neurologic and neurosurgical patients. The authors provide pertinent basic, clinical, diagnostic, and management guidelines for all the conditions commonly encountered in the neurocritical care unit, including the management of autonomic disorders that require critical care, postoperative management, and endovascular treatment. The authors also discuss the latest developments in the monitoring of different body systems, emphasizing the management of cardiorespiratory complications and other medical conditions that may threaten the patient's life. Also detailed are the concepts of intracranial physiology and current neuromonitoring techniques, subjects whose understanding is basic to effective management of critically ill neurologic patients. Numerous tables, figures, diagrams, and radiographs simplify and explicate both the diagnostic and therapeutic processes.

This unique text takes a comprehensive approach to the care of patients with neurologic catastrophes immediately after their entry into the emergency department. Wijdicks discusses clinical evaluations, triage, and emergency procedures in detail, and covers many other topics. For this thoroughly updated second edition, he has added eight new chapters, seven of which appear in an entirely new first section on the evaluation of presenting symptoms indicating urgency. The conversational titles of these chapters echo common requests for urgent consultation (e.g. "short of breath," "can't walk or stand," "confused and febrile"). A special feature of this section is the use of algorithms and decision trees in triage - to help the physician make a very fast and yet informed decision. The remaining two sections of the book cover the evaluation and management of evolving catastrophes in the neuraxis and catastrophic neurologic disorders due to specific causes. There is a final new chapter on forensic neurology. This practical handbook will continue to be an invaluable guide for neurologists, neurosurgeons, neuroradiologists, emergency physicians, and their residents and fellows. The third volume in the author's trilogy on critical care neurology, it combines the images of a neuroradiology text with the practical advice of an emergency neurology manual without compromising academic rigor.

During the 1990's, scientific advances in understanding the mechanisms and pathophysiology of acute central nervous system injury were offset by a history of disappointing results from Phase III clinical trials of novel neuroprotective drugs. Numerous novel compounds were "tested, and seemingly fell by the wayside. This book is intended to focus on novel therapies and the unique challenges their intended targets pose for the design and analysis of clinical trials. The authors explore the issues facing research in this area and the strategies that might lead to future success in this critical area of unmet medical need. It represents a compendium of information gained from over 20 years of clinical trial experience in areas of acute neurology and neurosurgery. From the knowledge of clinical assessment using standardized tools, to the intricate design of difficult hyper-acute neuroemergencies trials, the reader will benefit from the authors' perspectives. * Presents new perspectives on acute neuroemergency clinical trials * Includes insights from clinical pharmacology and industry perspectives * Discusses historical lessons learned from early and recent trials in acute neuroscience populations