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Brain Sciences
Special Issues
Neurocritical Care and Cerebrovascular Health
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Neurocritical Care and Cerebrovascular Health

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Neurotechnology and Neuroimaging".

Deadline for manuscript submissions: closed (29 January 2021) | Viewed by 22574

Special Issue Editor

Dr. Daniel Milej

E-Mail Website
Guest Editor
Imaging Division, Lawson Health Research Institute, London, ON, Canada
Interests: brain imaging; biomedical optics; functional neuroimaging; fNIRS; diffuse correlation spectroscopy; biomedical signal processing
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The daily practice of neurocritical care focuses on the monitoring and treatment of children and adults suffering from a wide range of neurological disorders. A variety of techniques are continuously being developed to further improve the diagnosis, prognosis, and treatment of patients with acute head and spinal injuries, subarachnoid and intracranial hemorrhages, cerebral vascular abnormalities, tumours, intracranial pressure issues, infectious diseases, patients in comatose states, etc. Timely diagnosis, efficient intervention, and accurate monitoring of the condition are crucial to patient outcome. In this Special Issue, we would like to invite all contributions that demonstrate an improvement in cerebrovascular health monitoring or in the treatment of major brain injuries or neurological disorders.

Topics include (but are not limited to) the following areas: cerebrovascular health monitoring using Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) neuroimaging techniques, multi-modality neuromonitoring, EEGs, brain tissue perfusion monitoring, intracranial pressure monitoring, cerebral oxygenation monitoring, biomarkers.

The article may be either original research or a review. There is no length restriction.

Dr. Daniel Milej
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Brain Sciences is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Cerebral blood flow
  • Blood-brain barrier
  • ICP
  • Brain oxygenation
  • Biomarkers
  • Magnetic Resonance Imaging

Published Papers (4 papers)

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Research

Jump to: Review, Other

13 pages, 1532 KiB  
Article
Perfusion and Metabolic Neuromonitoring during Ventricular Taps in Infants with Post-Hemorrhagic Ventricular Dilatation
by Ajay Rajaram, Lawrence C. M. Yip, Daniel Milej, Marianne Suwalski, Matthew Kewin, Marcus Lo, Jeffrey J. L. Carson, Victor Han, Soume Bhattacharya, Mamadou Diop, Sandrine de Ribaupierre and Keith St. Lawrence
Brain Sci. 2020, 10(7), 452; https://doi.org/10.3390/brainsci10070452 - 15 Jul 2020
Cited by 23 | Viewed by 3781
Abstract
Post-hemorrhagic ventricular dilatation (PHVD) is characterized by a build-up of cerebral spinal fluid (CSF) in the ventricles, which increases intracranial pressure and compresses brain tissue. Clinical interventions (i.e., ventricular taps, VT) work to mitigate these complications through CSF drainage; however, the timing of [...] Read more.
Post-hemorrhagic ventricular dilatation (PHVD) is characterized by a build-up of cerebral spinal fluid (CSF) in the ventricles, which increases intracranial pressure and compresses brain tissue. Clinical interventions (i.e., ventricular taps, VT) work to mitigate these complications through CSF drainage; however, the timing of these procedures remains imprecise. This study presents Neonatal NeuroMonitor (NNeMo), a portable optical device that combines broadband near-infrared spectroscopy (B-NIRS) and diffuse correlation spectroscopy (DCS) to provide simultaneous assessments of cerebral blood flow (CBF), tissue saturation (StO2), and the oxidation state of cytochrome c oxidase (oxCCO). In this study, NNeMo was used to monitor cerebral hemodynamics and metabolism in PHVD patients selected for a VT. Across multiple VTs in four patients, no significant changes were found in any of the three parameters: CBF increased by 14.6 ± 37.6% (p = 0.09), StO2 by 1.9 ± 4.9% (p = 0.2), and oxCCO by 0.4 ± 0.6 µM (p = 0.09). However, removing outliers resulted in significant, but small, increases in CBF (6.0 ± 7.7%) and oxCCO (0.1 ± 0.1 µM). The results of this study demonstrate NNeMo’s ability to provide safe, non-invasive measurements of cerebral perfusion and metabolism for neuromonitoring applications in the neonatal intensive care unit. Full article
(This article belongs to the Special Issue Neurocritical Care and Cerebrovascular Health)
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Review

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10 pages, 811 KiB  
Review
Which Target Temperature for Post-Anoxic Brain Injury? A Systematic Review from “Real Life” Studies
by Andrea Minini, Filippo Annoni, Lorenzo Peluso, Elisa Gouvêa Bogossian, Jacques Creteur and Fabio Silvio Taccone
Brain Sci. 2021, 11(2), 186; https://doi.org/10.3390/brainsci11020186 - 03 Feb 2021
Cited by 13 | Viewed by 2798
Abstract
There is a persistent debate on the optimal target temperature to use during cooling procedures in cardiac arrest survivors. A large randomized clinical trial (RCT) including more than 900 patients showed that targeted temperature management (TTM) at 33 °C had similar mortality and [...] Read more.
There is a persistent debate on the optimal target temperature to use during cooling procedures in cardiac arrest survivors. A large randomized clinical trial (RCT) including more than 900 patients showed that targeted temperature management (TTM) at 33 °C had similar mortality and unfavorable neurological outcome (UO) rates as TTM at 36 °C in out-of-hospital cardiac arrest patients with any initial rhythm. Since then, several observational studies have been published on the effects of changes in target temperature (i.e., from 33 to 36 °C) on patients’ outcome. We performed a systematic literature search from 1 January 2014 to 4 December 2020 and identified ten retrospective studies (very low levels of certainty; high risk of bias), including 5509 patients, that evaluated TTM at 33 °C vs. TTM at 36 °C on the occurrence of UO (n = eight studies) and mortality (n = ten studies). TTM at 33 °C was associated with a lower risk of UO when studies assessing neurological outcome with the Cerebral Performance Categories were analyzed (OR 0.80 [95% CIs 0.72–0.98]; p = 0.03). No differences in mortality were observed within the two TTM strategies. These results suggest that an inappropriate translation of TTM protocols from large well-conducted randomized trials into clinical management may result in unexpected effects on patients’ outcome. As for all newly commercialized drugs, epidemiological studies and surveillance programs with an adequate follow-up on large databases are necessary to understand how RCTs are implemented into medical practice. Full article
(This article belongs to the Special Issue Neurocritical Care and Cerebrovascular Health)
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Other

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6 pages, 2214 KiB  
Case Report
Brain Abscess Masquerading as Brain Infarction
by Da-Eun Jeong and Jun Lee
Brain Sci. 2020, 10(7), 440; https://doi.org/10.3390/brainsci10070440 - 11 Jul 2020
Cited by 1 | Viewed by 6305
Abstract
Occasionally, acute ischemic stroke can be difficult to differentiate from acute intracranial infection. We describe a patient who presented with sudden onset of right hemiparesis and fever. Magnetic resonance imaging (MRI) was consistent with an acute stroke, showing multiple lesions with restricted diffusion [...] Read more.
Occasionally, acute ischemic stroke can be difficult to differentiate from acute intracranial infection. We describe a patient who presented with sudden onset of right hemiparesis and fever. Magnetic resonance imaging (MRI) was consistent with an acute stroke, showing multiple lesions with restricted diffusion in the left middle cerebral artery territory. These lesions were not enhancing and were not associated with vasogenic edema. A diagnosis of acute stroke was made based on the clinical and radiographic data. Follow-up MRI obtained eleven days later showed interval development of ring enhancement and vasogenic edema surrounding the previously noted core of restricted diffusion. Based on these findings, the diagnosis was revised to cerebral abscesses and the patient was treated successfully with antibiotics. In retrospect, the largest diffusion-weighted lesion on baseline MRI demonstrated two characteristics that were atypical for stroke: it had an ovoid shape and a subtle T2 hypointense core. This case demonstrates that acute clinical and radiographic presentation of cerebral abscess and ischemic stroke can be strikingly similar. Follow-up imaging can be instrumental in arriving at an accurate diagnosis. Full article
(This article belongs to the Special Issue Neurocritical Care and Cerebrovascular Health)
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6 pages, 1490 KiB  
Case Report
Neisseria meningitidis Induced Fatal Waterhouse–Friderichsen Syndrome in a Patient Presenting With Disseminated Intravascular Coagulation and Multiple Organ Failure
by Meng-Yu Wu, Chien-Sheng Chen, Chih-Yi Tsay, Giou-Teng Yiang, Jian-Yu Ke and Po-Chen Lin
Brain Sci. 2020, 10(3), 171; https://doi.org/10.3390/brainsci10030171 - 17 Mar 2020
Cited by 6 | Viewed by 9197
Abstract
Neisseria meningitidis-induced acute systemic meningococcal disease is an emergency and a fatal condition that has a high mortality rate. In patients with a fulminant infection, a maculopapular petechial eruption, purpura fulminans, or an ecchymotic lesion are worrisome signs reflecting disseminated intravascular coagulation [...] Read more.
Neisseria meningitidis-induced acute systemic meningococcal disease is an emergency and a fatal condition that has a high mortality rate. In patients with a fulminant infection, a maculopapular petechial eruption, purpura fulminans, or an ecchymotic lesion are worrisome signs reflecting disseminated intravascular coagulation (DIC) and hint at Waterhouse–Friderichsen syndrome (WFS). Here, we describe a rare case of a patient with a fulminant Neisseria meningitidis-induced acute systemic meningococcal disease presenting with high-grade fever without meningitis symptoms. Fatal septicemia with DIC and multiple organ failure was noted. WFS was chiefly suspected. We highlight the clinical features and pathogenesis of Neisseria meningitidis-induced meningococcemia and WFS. We propose that they should be kept in mind, especially in patients presenting with a petechial eruption and purpura fulminans. Full article
(This article belongs to the Special Issue Neurocritical Care and Cerebrovascular Health)
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