Wijdicks, Eelco F. M.

Abstract This book is an invaluable review of neurologic critical care in the intensive care unit. The emphasis is on management in day-to-day practice. Part I is devoted to basic management of critically ill patients with acute neurologic diseases. Part II covers the technology and procedures used in the intensive care unit. Part III discusses the management of specific disorders in critical care neurology. Part IV deals with the management of postoperative neurosurgical complications. Part V covers the management of systemic complications. The final section, Part VI, discusses decisions at the end of life and other responsibilities. An appendix is devoted to the calculation of important variables and provides reference tables for daily practice. For quick reference in the intensive care unit the most useful tables and figures have been extracted by the author and reprinted in an accompanying pocket-sized booklet. For this thoroughly revised second edition, there are five new chapters on the organization of the intensive care unit and code of conduct of the neurointensivist, acute spinal disorders, the management of common postoperative neurosurgical complications (two chapters), ethics and legal problems, and withdrawal of life support. Also new to this edition are algorithms on outcome prediction in the specific disorders. This scholarly and yet accessible and practical book spans the entire field of acute neurology but remains cohesive as it is single-authored. Like the first edition, the second will be widely used by neurologists, specialists in neurologic intensive care, neurologists training in neurologic critical care and stroke fellowships, anesthesiologists, neurosurgeons, critical care specialists of all types, emergency physicians, residents in neurology and neurosurgery, and neuroscience nurses.

Guillain-Barré syndrome (GBS) describes a neurological syndrome characterised by acute, areflexic paralysis, often preceded by an immune stimulating event such as infection or surgery. Spinal surgery as an inciting event is very uncommon with few reported cases. When paraparesis develops in close proximity of surgery, surgical complications should be considered, but if an asymptomatic clinical interval precedes a progressive ascending weakness this association weakens and may support an immunological mechanism. GBS after lumbar surgery is wholly unexpected and thus there are significant challenges in recognising and making the diagnosis. We report a case of fulminant GBS that progressed to loss of all motor function following elective lumbar spine surgery.

Abstract Consults in the intensive care unit to evaluate and manage acute neurologic clinical problems are usually of considerable complexity. This comprehensive book will assist the neurologist to recognize and treat complex neurological complications in critically ill patients admitted to medical, surgical, trauma, and transplant intensive care units. Every chapter provides a representative selection of the state-of-the-art management in the intensive care unit, necessary for an understanding of critical care medicine. It offers practical advice on how to best deal with coma after cardiopulmonary resuscitation, failure to awaken after surgery, delirium, new-onset seizures, generalized weakness, acute paraplegia, movement disorders, and many other manifestations of a neurologic emergency. Other topics include neurologic complications after organ transplantation; spinal cord injury after thoracoabdominal surgery; neurologic complications of invasive procedures and devices; complications from cardiac surgery; traumatic brain, spine, and peripheral nerve injury; and less common environmental injuries such as hypothermia and near-drowning. This book also addresses end-of-life care and the responsibilities of the consulting neurologist.