Volume 7 - Issue 1

Opinion Biomedical Science and Research Biomedical Science and Research CC by Creative Commons, CC-BY

New Perspectives in the Treatment of Neurocritical Patient

*Corresponding author: Luis Alberto Camputaro, University of Buenos Aires, Intensive Care Division, Coordinator Neurovascular Neurointensive Care, Hospital Juan A Fernandez, Buenos Aires, Argentina.

Received: January 09, 2020; Published: January 24, 2020

DOI: 10.34297/AJBSR.2020.07.001111


The vision of the Neurocritical patient has certainly changed in recent decades. This has allowed us better results in our patients from survival to the quality-quantity of sequelae.

What have been the reasons for this change, from our perspective?

1. We have managed to better categorize the risk from the diagnosis of neurological injury with more and better images (CT Scan, PET Scan, MRI, DSA, Tractography, etc.)

2. Our knowledge of pathophysiology has improved beyond primary damage. We know better the mechanisms that are triggered in each acute neurological injury causing secondary damage. From the different inflammatory mechanisms; alterations in Cerebral Blood Flow (FSC) due to loss of selfregulation, and its particular temporal behavior in each particular pathology [1, 2] ; to the intricate mechanisms of apoptosis. Thus, we have also generated new knowledge about the interrelationships that produce systemic impact in the face of the different Neurological insults [3].

3. The development of new technology allows us to visualize these pathophysiological phenomena, giving us more and better opportunities for therapeutic intervention [4, 5] . Among others: Measurement of Intracranial Pressure (ICP) directly through various devices available or indirect through measurement of Optical Nerve Sheath Diameter (ONSD) or Transcranial Döppler (TCD); balance in brain oxygenation through Yugular Bulb, Near-Infrared Spectrometry or O2 Tissue Pressure PtiO2; electrical alterations through continuous EEG; metabolism alterations through Brain Micro-dialysis, etc.

4. The generation of Consensus and Guidelines allow us to use strategies with varied evidence, agreed between the different actors involved in the Neurocritical Patient treatment (Emergency Physicians, Neurologists, Neurosurgeons, Intensive Care Physicians, Cardiologists); met with the paramedical and nursing staf. This aspect has allowed us, beyond improving the results; to be able to exchange information in a more regulated and uniform manner.

But there is still a challenge to be left: to generate more Trained Human Resource for the Neurocritical Patient Treatment, as we must ensure that attention is done from these new perspectives from their first assistance [6].

Our challenge for the new generations, from a new vision; continue to improve the quality of care of our patients by impacting better results in a number of pathologies that year after year occupy more space in the concern of public health in our countries.


Sign up for Newsletter

Sign up for our newsletter to receive the latest updates. We respect your privacy and will never share your email address with anyone else.