Proceedings of
Neurocritical Care 2003: Here Comes the Sun
A Global Summit on Critical Care for Cerebrovascular Disease

September 5-6, 2003
Cleveland, Ohio

Summit Directors and Editors:

Michael A. De Georgia, MD
Derk Krieger, MD, PhD
Anthony Furlan, MD
The Cleveland Clinic

Special Issue
January 2004

Supplement 1 to Volume 71

 

 

 

 

 

 

 

 

 

 

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Table of Contents*

HISTORICAL PERSPECTIVES: NEUROINTENSIVE CARE

The development of neurologic intensive care...................................................................S4
ALLAN H. ROPPER, MD
St. Elizabeth's Medical Center and
Tufts University School of Medicine, Boston, Mass.

INTRACRANIAL PRESSURE

The pathophysiology of brain edema and elevated intracranial pressure.....................S6
ANTHONY MARMAROU, PhD
Virginia Commonwealth University Medical Center, Richmond, Va.

Hypertonic saline for cerebral edema and elevated intracranial pressure....................S9
JOSE I. SUAREZ, MD
University Hospitals of Cleveland and
Case Western Reserve University, Cleveland, Ohio

Every breath you take: Hyperventilation and intracranial pressure............................S14
CLAUDIA ROBERTSON, MD
Baylor College of Medicine, Houston, Tex.

Multimodal monitoring in neurocritical care...................................................................S16
MICHAEL A. DE GEORGIA, MD
The Cleveland Clinic Foundation, Cleveland, Ohio

HEMORRHAGIC STROKE

Endovascular coiling: The end of conventional neurosurgery?....................................S18
PETER A. RASMUSSEN, MD
The Cleveland Clinic Foundation, Cleveland, Ohio

FUNDAMENTALS OF CRITICAL CARE

Lessons from the medical and surgical ICU.......................................................................S19
J. JAVIER PROVENCIO, MD
The Cleveland Clinic Foundation, Cleveland, Ohio

HISTORICAL PERSPECTIVES: CEREBROVASCULAR DISEASE

Cerebrovascular disease: Historical background, with an eye to the future................S22
LOUIS R. CAPLAN, MD
Harvard Medical School and
Beth Israel Deaconess Medical Center, Boston, Mass.

ACUTE ISCHEMIC STROKE

Pathophysiology of acute ischemic stroke.........................................................................S25
MIDORI A. YENARI, MD
Stanford University, Stanford, Calif.

Intravenous thrombolysis for acute stroke.......................................................................S28
JOSEPH P. BRODERICK, MD
University of Cincinnati College of Medicine, Cincinnati, Ohio

Intra-arterial thrombolysis for acute stroke......................................................................S31
ANTHONY FURLAN, MD
The Cleveland Clinic Foundation, Cleveland, Ohio

Therapeutic hypothermia may enhance reperfusion in acute ischemic stroke.........S39
DERK W. KRIEGER, MD, PhD
The Cleveland Clinic Foundation, Cleveland, Ohio

Stem cell transplantation for stroke....................................................................................S40
LAWRENCE R. WECHSLER, MD
University of Pittsburgh Medical School

EXTRACRANIAL DISEASE

Carotid artery disease: From knife to stent........................................................................S42
MARC R. MAYBERG, MD
The Cleveland Clinic Foundation, Cleveland, Ohio

Carotid stenting in high-risk patients: Design and rationale of the SAPPHIRE trial...S45
JAY S. YADAV, MD
The Cleveland Clinic Foundation, Cleveland, Ohio

INTRACRANIAL DISEASE

Medical management of intracranial atherosclerosis: Current state of the art...........S47
CATHY A. SILA, MD
The Cleveland Clinic Foundation, Cleveland, Ohio

Intracranial stenting: Which patients and when?.............................................................S50
RANDALL T. HIGASHIDA, MD
University of California, San Francisco, Medical Center

ANTITHROMBOTIC THERAPY

Anticoagulation for stroke prevention: Yes, no, maybe..................................................S52
J.P. MOHR, MD
The Neurological Institute, New York, N.Y.

Antiplatelet therapy for acute stroke: Aspirin and beyond.............................................S57
CATHY A. SILA, MD
The Cleveland Clinic Foundation, Cleveland, Ohio

Abstracts/Poster Presentations (Click here for the entire collection of abstracts).....S60

Abstract 1
Hyponatremia-related focal cerebral edema, a mimic of worsening cerebral edema due to intracerebral hemorrhage
P. WIDDESS-WALSH, V. SABHARWAL

Abstract 2
Suboccipital craniectomy for acute cerebellar ischemic stroke
B.R. COHEN, G.L. BERNARDINI, D. FRIEDLICH, A.J. POPP

Abstract 3
The feasibility and safety of mild brain hypothermia obtained by local surface cooling in acute stroke
K. YAMADA, H. MORIWAKI, H. OE, K. MIYASHITA, K. NAGATSUKA, T. YAMAWAKI, H. NARITOMI

Abstract 4
The Diverter, a novel permanent arterial diversion device
J. LEOR, Y. GRAD, O. OZ, Y. ASSAF

Abstract 5
Fatal arrhythmia in an anxious patient during recovery from lateral medullary infarction
J.G. LATTORE
 

Abstract 6
Motor, behavioral, and cognitive changes in patients with thalamic lesions
A.V. SRINIVASAN, B.S. VIRUDHAGIRINATHAN, C.U. VELMURUGENDRAN

Abstract 7
Reversal of locked-in syndrome with anticoagulation, induced hypertension, and intravenous t-PA
K.E. WARTENBERG, N.S. JANJUA, S.A. MAYER, P. MEYERS

Abstract 8
Dantrolene reduces the threshold and gain for shivering
R. LENHARDT

Abstract 9
Predicting outcome after subarachnoid hemorrhage: Comparison of different grading systems
M. BERKER, A. DEOGAONKAR, V. SABHARWAL, P. RASMUSSEN, M. MAYBERG, M. DE GEORGIA

Abstract 10
Integrative monitoring methods in neurocritical care
A. DEOGAONKAR, A. VANDER KOUWE, K. HORNING, R. BURGESS, M. DE GEORGIA
*In addition to the presentations represented here, The Cleveland Clinic's Neurocritical Care 2003 Summit also included the following talks, which were not accompanied by written syllabus submissions for publication:
  • Impact of vascular disease on world health care---Marc Mayberg, MD (Introductory Presentation)
  • Blood pressure: Do we raise it or lower it? CPP protocol vs Lund protocol---Randall Chestnut, MD (Intracranial Pressure)
  • Decompressive craniectomy: Back to the future---Jeffrey Frank, MD (Intracranial Pressure)
  • Subarachnoid hemorrhage: From clip to coil---Neil Martin, MD (Hemorrhagic Stroke)
  • Cerebral vasospasm: Which H is the most important H?---Stephan Mayer, MD (Hemorrhagic Stroke)
  • Intracerebral hemorrhage: To evacuate or not to evacuate---A.D. Mendelow, MB, Bch, PhD (Hemorrhagic Stroke)
  • Lessons learned from head trauma---M. Ross Bullock, MD (Fundamentals of Critical Care)
  • The future of neurocritical care---Michael Diringer, MD (Fundamentals of Critical Care)
  • Neuroimaging of acute stroke---Thomas Masaryk, MD (Acute Ischemic Stroke)
  • Cardiac sources of embolism---Pierre Amarenco, MD (Acute Ischemic Stroke)
  • Beyond thrombolysis: Combination therapy and other strategies for reperfusion---Thomas Brott, MD (Acute Ischemic Stroke)
  • The future of cerebrovascular disease---Werner Hacke, MD (Antithrombotic Therapy)

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