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Neurologic Catastrophe in the CT ICU: A Neurosurgeon’s Dilemma

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Difficult Decisions in Cardiothoracic Critical Care Surgery

Part of the book series: Difficult Decisions in Surgery: An Evidence-Based Approach ((DDSURGERY))

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Abstract

Neurosurgical emergencies in the Cardiothoracic Surgery Intensive Care Unit (CTICU) are primarily comprised of intracerebral hemorrhages occurring as a result of thromboembolic ischemic infarction with hemorrhage conversion, falls resulting in traumatic hemorrhages and spontaneous hemorrhagic complications, all of which are complicated by the antithrombotic medication (ATM) regimens required for implanted cardiac devices. Ischemic cerebral infarctions requiring decompressive craniotomy may also occur but are not a focus of this chapter, which will instead concentrate on hemorrhagic intracranial complications related to ventricular assist devices and valve surgery in the absence of bacterial endocarditis or mycotic aneurysms. Resumption of antithrombotic medications after intracranial hemorrhage (ICH) in the face of thrombogenic cardiac devices is an oft-encountered clinical dilemma for which little data exist, and will also be discussed.

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Author information

Authors and Affiliations

  1. Department of Neurosurgery, Penn State University Milton S. Hershey Medical Center, Hershey, PA, USA

    Emily P. Sieg & Shelly D. Timmons

  2. Department of Cardiothoracic Surgery, Geisinger Health System, Danville, PA, USA

    Russell A. Carter

Authors
  1. Emily P. Sieg
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  2. Russell A. Carter
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  3. Shelly D. Timmons
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Corresponding author

Correspondence to Shelly D. Timmons .

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Editors and Affiliations

  1. University of Chicago Medicine, Chicago, IL, USA

    Vassyl A. Lonchyna

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Sieg, E.P., Carter, R.A., Timmons, S.D. (2019). Neurologic Catastrophe in the CT ICU: A Neurosurgeon’s Dilemma. In: Lonchyna, V. (eds) Difficult Decisions in Cardiothoracic Critical Care Surgery. Difficult Decisions in Surgery: An Evidence-Based Approach. Springer, Cham. https://doi.org/10.1007/978-3-030-04146-5_43

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  • DOI: https://doi.org/10.1007/978-3-030-04146-5_43

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-04145-8

  • Online ISBN: 978-3-030-04146-5

  • eBook Packages: MedicineMedicine (R0)

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