In this segment of ENLS Version 5.0 Pharmacotherapy Pearls, a case study is presented focusing on hyperosmolar therapy for intracranial pressure (ICP) control in a 25-year-old male with traumatic brain injury (TBI). The patient has received multiple doses of sodium chloride and mannitol within 24 ho

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A 75-year-old male post-sinus surgery developed tension pneumocephalus, causing intracranial air with mass effect and midline shift. Learn about its presentation, diagnosis, and management, including surgical decompression and conservative measures. Despite not needing surgery, the patient improved

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This content presents a series of quizzes involving diuretics and their role in clinical scenarios related to heart failure, glaucoma, renal hemodynamics, and intracranial pressure. Questions cover various diuretic agents such as furosemide, acetazolamide, mannitol, and hydrochlorothiazide, focusing

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In the severe traumatic brain injury (TBI) protocol, intracranial monitors measuring ICP and PbtO2 are placed within 12 hours of injury. Procedures include FiO2 challenges to check PbtO2 reliability and assess cerebral physiology. Challenges involving FiO2, MAP, and CO2 help guide ventilator setting

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Cerebral edema is a life-threatening condition that can result from various factors such as trauma, infarction, hemorrhages, or tumors. This condition can lead to increased morbidity and mortality due to hemorrhage or herniation. New advances in understanding the pathophysiology of cerebral edema ha

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Short-term goals for treating hemorrhagic stroke involve rapid neurointensive care to maintain adequate oxygenation, breathing, and circulation, along with managing increased intracranial pressure and blood pressure. Long-term management focuses on preventing complications, recurrent bleeding, delay

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A study by DJ Graham et al. compared the risks of stroke, bleeding, and mortality in elderly Medicare beneficiaries with nonvalvular atrial fibrillation treated with dabigatran or rivaroxaban. The study included over 118,000 patients and found that dabigatran was associated with a lower risk of majo

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Lumbar puncture, also known as LP, is an invasive procedure used to obtain cerebrospinal fluid (CSF) for diagnostic and therapeutic purposes. This procedure has a long history dating back to ancient times, with modern techniques developed in the late 19th century by Heinrich Quincke. LP is crucial f

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Lumbar puncture is a medical procedure involving the insertion of a needle into the spinal subarachnoid space to collect cerebrospinal fluid for diagnostic or therapeutic purposes. Indications for performing a lumbar puncture include suspicion of meningitis, subarachnoid hemorrhage, CNS diseases lik

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Head injuries pose a significant threat to morbidity and mortality, with causes ranging from motor accidents to child abuse and falls. Understanding the epidemiology and pathophysiology of head injuries is crucial for effective management. Primary and secondary brain injuries necessitate immediate c

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Understanding the pathophysiology of brain injuries, including intracranial pressure changes and specific injuries such as traumatic brain injury (TBI), skull fractures, brain bleeds, and diffuse axonal injuries. It covers classifications, diagnosis, and treatment approaches for mild/concussion, mod

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Craniopharyngioma is a complex intracranial tumor with a rich historical background dating back to the early 20th century. Initially described by McLean, Frazier, Alpes, and famously studied by Cushing, this tumor continues to be a subject of debate and controversy in terms of treatment approaches a

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