This book is meant to educate and assist any healthcare professional who has the privilege of caring for patients with acute stroke. Although it is particularly helpful for clinicians who are involved with critical decision making, practitioners at all levels of training can use the book as a guide. The practice of stroke medicine has become quite complex over the past two decades. Fortunately, this is for good reasons. The intricacies associated with management of ischemic and hemorrhagic strokes reflect improved understanding of the disease process, advances in neuroimaging, and development of novel treatment options. In the first 24 to 72 hours of hospitalization, stroke patients are susceptible to a whole host of cerebral (neurological) and extracerebral (medical) complications. Being familiar with these complications and having the knowledge to properly identify and manage them can reduce length of hospital stay, adverse functional outcomes, and mortality. This book hopes that practitioners will appreciate acute stroke management as a dynamic process and understand the uniqueness of acute stroke as a clinical entity with its potential for complications that may be a direct or indirect consequence of the initial brain injury. The book consists of fifteen chapters. Chapter one provides an introduction to complications of acute stroke. Chapter two discusses cerebral ischemic infarction. Next three chapters focus on expansion of intracerebral hemorrhage; cerebral edema in stroke; and post-thrombolysis hemorrhage and hemorrhagic transformation of cerebral infarction. Chapters six and seven discuss endovascular and postprocedural complications and reperfusion injury in ischemic stroke. The next two chapters focus on stroke-related seizures, rebleeding, vasospasm, and hydrocephalus after subarachnoid Hemorrhage. Chapter ten describes the complications of cerebral venous thrombosis. The following four chapters discuss complications after stroke such as delirium, cardiac complications, pulmonary complications, and metabolic complications. The last chapter briefly describes poststroke infections.
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Since its recognition as a subspecialty in 2005, the neurocritical care community has significantly grown. An increasing number of hospitals across the United States provide subspecialized neurocritical care, and fellowship-trained neurointensivists are in demand more than ever. This book is intended to be a comprehensive study guide and self-assessment tool for candidates sitting for both initial certification and recertification in neurocritical care. In addition, trainees taking the surgical or medicine critical care boards will also find it useful as it covers the neurocritical care component of their board curriculums. The book is an easy-to-read, concise yet comprehensive, and portable learning resource not only for board preparation, but also for medical students, residents, and fellows rotating in the neurocritical care unit. Nurses, advance practice providers, and non-neurointensivist physicians who participate in the care of neurocritical care patients will also find this book to be an easy guide to the management of many frequently encountered issues, with case examples and imaging to further guide their education. The chapters are named and arranged in a similar format to the board curriculum to allow for easy review and organization when studying for the boards. The question-and-answer (Q&A) format allows the reader to perform thorough self-assessment prior to taking the exam. The answers are detailed and cover the majority of the board syllabus with updated references for additional reading. The book covers the key topics pertinent to (and found on) neurocritical care boards, and is organized according to the exam core curriculum outline. The questions address both neuroscience critical care (general neurology, neurotrauma, neurovascular and neurosurgical problems) and general critical care topics (systems trauma, cardiovascular, infectious disease, pulmonary and renal issues, and hemodynamic monitoring).