Despite proven benefits, few brain aneurysm patients receive specialized care
The Neurocritical Care Society is releasing a comprehensive set of guidelines this week to guide physicians and hospitals on how to optimally care for patient's ruptured brain aneurysms. One of the strongest recommendations is that all patients receive specialized care at high-volume stroke centers that treat at least 60 cases per year.
Subarachnoid hemorrhage strikes without warning and results from rupture of an artery supplying the brain. Thirty percent do not survive, and half of those who do are permanently disabled.
The recommendation that patients receive care at high-volume centers is based on a comprehensive analysis of medical outcomes research conducted by an international panel of experts. The report found that relatively fewer patients are treated at high-volume centers, despite overwhelming evidence that care in more experienced centers will most likely result in definitive repair of the aneurysm and a good recovery.
"One important reason for better outcomes in large volume centers is that care is provided by specialized neurocritical care teams," said Dr. Paul Vespa, Director of Neurocritical Care at UCLA Medical Center and lead author of the report. "Once bleeding from the aneurysm is controlled, highly-specialized ICU care is required to detect and treat secondary complications. These complications are often just as deadly, if not more so, than the bleeding event."
Studies indicate that patients who come to a hospital with little experience in managing subarachnoid hemorrhage are rarely transferred to high-volume centers. "The main reason that patients are not transferred is that stroke care is not regionalized in the same way that it is for trauma. It is a patchwork system; sometimes it works, but more often it does not," says Dr. Stephan A. Mayer, Director of Neurocritical Care at Columbia University Medical Center and President of the Neurocritical Care Society.
Medical guidelines play an important role in guiding doctors, hospitals, and public policy as it relates to healthcare. According to Michael N. Diringer, Professor of Neurology and Neurosurgery at Washington University and Director of the Neurology/Neurosurgery Intensive Care Unit at Barnes-Jewish Hospital in St Louis, who chaired the consensus conference and co-authored the report, "None of the specific medications or treatments that we analyzed made nearly as much difference as where the patient is initially taken for treatment. These guidelines will hopefully alert patients, doctors, and hospital systems to the importance of regionalized care for brain aneurysm victims."
More information: View the full summary report at: www.springerlink.c… 28013214524/
Provided by Neurocritical Care Society
- Study supports alternative anti-seizure medication following acute brain injury Feb 17, 2010 | not rated yet | 0
- New measures could improve quality of care at stroke centers Jan 13, 2011 | not rated yet | 0
- Choice of hospital impacts outcomes for inflammatory bowel disease surgery Jun 18, 2008 | not rated yet | 0
- Referral to high-volume hospitals for operations fails to improve outcomes statewide Mar 10, 2011 | not rated yet | 0
- Underpriveleged patients not as likely to be referred to specialty hospitals for brain tumors Mar 15, 2010 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Pressure-volume curve: Elastic Recoil Pressure don't make sense
7 hours ago From pressure-volume curve of the lung and chest wall (attached photo), I don't understand why would the elastic recoil pressure of the lung is...
If you became brain-dead, would you want them to pull the plug?
May 17, 2013 I'd want the rest of me to stay alive. Sure it's a lousy way to live but it beats being all-the-way dead. Maybe if I make it 20 years they'll...
MRI bill question
May 15, 2013 Dear PFers, The hospital gave us a $12k bill for one MRI (head with contrast). The people I talked to at the hospital tell me that they do not...
Ratio of Hydrogen of Oxygen in Dessicated Animal Protein
May 13, 2013 As an experiment, for the past few months I've been consuming at least one portion of Jell-O or unflavored Knox gelatin per day. I'm 64, in very...
Alcohol and acetaminophen
May 13, 2013 Edit: sorry for the typo in the title , can't edit I looked around on google quite a bit and it's very hard to find precise information on the...
Marie Curie's leukemia
May 13, 2013 Does anyone know what might be the cause of Marie Curie's cancer
- More from Physics Forums - Medical Sciences
More news stories
For combat veterans suffering from post-traumatic stress disorder, 'fear circuitry' in the brain never rests
Chronic trauma can inflict lasting damage to brain regions associated with fear and anxiety. Previous imaging studies of people with post-traumatic stress disorder, or PTSD, have shown that these brain regions can over-or ...
Neuroscience 10 hours ago | not rated yet | 0 |
The neural machinery underlying our olfactory sense continues to be an enigma for neuroscience. A recent review in Neuron seeks to expand traditional ideas about how neurons in the olfactory bulb might encode information about ...
Neuroscience 21 hours ago | not rated yet | 0 |
(Medical Xpress)—What if the quality of your work depends more on your focus on the piano keys or canvas or laptop than your musical or painting or computing skills? If target users can be convinced, they ...
Neuroscience 21 hours ago | 3.7 / 5 (3) | 0 |
Neurological disorders can have a devastating impact on the lives of sufferers and their families.
Neuroscience May 17, 2013 | 5 / 5 (1) | 0 |
If you're a left-brain thinker, chances are you use your right hand to hold your cell phone up to your right ear, according to a newly published study from Henry Ford Hospital in Detroit.
Neuroscience May 16, 2013 | 2 / 5 (2) | 0 |
An increasing number of U.S. children are experiencing gastrointestinal issues that require interventions to resolve, according to research presented at Digestive Disease Week (DDW).
1 hour ago | not rated yet | 0 |
A ground-breaking advance in colonoscopy technology signals the future of colorectal care, according to research presented today at Digestive Disease Week(DDW). Additional research focuses on optimizing the minimal withdrawal ...
58 minutes ago | not rated yet | 0
Big names in medicine are set to give an upbeat assessment of the war on AIDS on Tuesday, 30 years after French researchers identified the virus that causes the disease.
9 hours ago | 5 / 5 (1) | 0
In 2008 researchers from the University of Southern Denmark showed that the drug thioridazine, which has previously been used to treat schizophrenia, is also a powerful weapon against antibiotic-resistant bacteria such as ...
18 hours ago | 3.7 / 5 (3) | 0 |
Treatment for alcohol use disorders works best if the patient actively understands and incorporates the interventions provided in the clinic. Multiple factors can influence both the type and degree of neurocognitive abnormalities ...
19 hours ago | not rated yet | 0 |
In order to avoid harms associated with alcohol consumption, in 2009 the National Institute on Alcohol Abuse and Alcoholism issued guidelines that define low-risk drinking. These guidelines differ for men and women: no more ...
19 hours ago | not rated yet | 0 |