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Apr 28, 20120 likes1,564 views

This document discusses hyponatremia in neurological patients, specifically comparing cerebral salt wasting syndrome (CSW) and syndrome of inappropriate antidiuretic hormone secretion (SIADH). It notes that hyponatremia is common in acute neurological patients and can worsen outcomes. The key difference between CSW and SIADH is volume status, which is difficult to assess, though treatment differs with fluid restriction for SIADH and saline replacement for CSW. Correct diagnosis and management of hyponatremia in these patients is important.

Mechanical thrombectomy in acute stroke [Autosaved].pptxNeurologyKota

1. The document discusses various techniques for mechanical thrombectomy in acute stroke, including thrombectomy devices, thromboaspiration, and thrombolysis. 2. It summarizes key trials investigating mechanical thrombectomy including DAWN, DEFUSE 3, and a basilar artery occlusion trial. The DAWN and DEFUSE 3 trials showed improved outcomes with thrombectomy plus standard care compared to standard care alone for certain patients. 3. The document outlines considerations for implementing a mechanical thrombectomy program, including patient selection criteria, imaging guidance, procedural timelines, equipment needs, and cost estimates.

Cardiac Resynchronization Therapy and ICDsAhmed Mahmood

Cardiac resynchronization therapy (CRT) uses an implanted device to resynchronize heart ventricle contractions, improving heart pumping efficiency. CRT-Ds additionally treat abnormal heart rhythms. CRT benefits include improved hemodynamics, reduced heart remodeling, and reduced hospitalizations and mortality. CRT is indicated for patients with left ventricular dysfunction, heart failure symptoms, and prolonged QRS duration, especially over 150ms with left bundle branch block. Randomized trials show CRT effectiveness includes these benefits compared to conventional therapy.

Anaesthesia for supratentorail massDhritiman Chakrabarti

The document discusses the anatomy and functions of the brain, focusing on the supratentorial and infratentorial compartments. It then discusses considerations for anesthesia during brain surgery, including techniques to minimize increases in intracranial pressure and prevent complications like venous air embolism. Key goals are to keep the patient hemodynamically stable and allow for postoperative neurological assessment.

Edward Fohrman | Anesthesia for Pituitary SurgeryEdward Fohrman

Perioperative cardiovascular evaluation for non cardiac surgeryPROFESSOR DR. MD. TOUFIQUR RAHMAN

This document provides guidelines for perioperative cardiovascular evaluation and management for patients undergoing non-cardiac surgery. It discusses preoperative clinical evaluation, testing, management of specific cardiovascular conditions, supplemental evaluation like ECG and stress testing, considerations for patients with prior coronary revascularization, perioperative medical therapy, intraoperative management, postoperative surveillance and long-term management. The document provides a stepwise approach and recommendations for evaluation and treatment of cardiovascular issues in the perioperative period.

Rapid Sequence Intubation (RSI)OscarKwan6

Rapid sequence intubation (RSI) is an emergency method used to safely and rapidly intubate a patient's airway while minimizing the risks of regurgitation and aspiration. The steps of RSI include preoxygenation, positioning the patient, administering premedication, applying cricoid pressure, rapidly inducing unconsciousness with drugs like propofol or ketamine, paralyzing the patient with succinylcholine or rocuronium, intubating the trachea, and providing post-intubation care and ventilation. RSI aims to protect patients from complications of aspiration that can occur if the airway is not properly protected during emergency intubation.

ANATOMY OF SUBARACHNOID CISTERNS OF BRAINPiyushThombare

The document discusses various subarachnoid cisterns in the brain. It describes the location and contents of key supratentorial cisterns like the carotid, chiasmatic, lamina terminalis, olfactory, and sylvian cisterns. It also describes infratentorial cisterns such as the interpeduncular, prepontine, ambient, and cisterna magna. The document traces the historical understanding of the subarachnoid space and cisterns and provides diagrams to illustrate locations. Knowledge of the cisterns' contents is important for neurosurgeons planning intracranial procedures.

Coronary sinus reviewSmita Patil-Pawar

The document discusses the anatomy of the coronary sinus and its tributaries. It provides details on: - The coronary sinus drains into the right atrium and receives blood from the ventricular veins. Its tributaries include the anterior interventricular vein, great cardiac vein, left marginal vein, and middle cardiac vein. - The document describes the normal anatomy and variations of the coronary sinus that can be identified on imaging. It also discusses the embryological development and valves within the coronary sinus. - Understanding coronary sinus anatomy is important for electrophysiology procedures and surgeries that utilize the coronary sinus, such as pacing and ablation procedures.

Amadeus ticket changer guia de referencia rápidaamadeus1ar

Este documento proporciona información sobre las transacciones de Amadeus Ticket Changer para la tarifa más económica disponible. Explica cómo utilizar las entradas FXE y FXO para cotizar un nuevo PNR y aplicar la tarifa más baja, ya sea sin cambios a la clase reservada o realizando cambios si es necesario. También describe los pasos para emitir los boletos y realizar reemisiones utilizando transacciones como TTP, TTP/P1 y FPO/CA.

Measurement of Cerebral Blood FlowDr Kaushal Deep Singh Mathuria

This document summarizes techniques for clinically measuring cerebral blood flow (CBF). It discusses the historical background and development of CBF measurement. Currently available clinical techniques include stable xenon-enhanced CT, PET, SPECT, intracarotid xenon studies, CT perfusion imaging, and MRI perfusion imaging. Xenon-enhanced CT provides whole-brain CBF maps but requires specialized equipment. SPECT and intracarotid xenon studies are more widely accessible. CT perfusion imaging allows CBF, cerebral blood volume, and mean transit time mapping but with limited brain coverage. Examples and advantages/disadvantages of each technique are provided.

HISTORY EVOLUTION OF ECG.pptxPraveen Nagula

Lown ganong-levine syndromehttps://aiimsbhubaneswar.nic.in/

Lown-Ganong-Levine Syndrome is a condition where there is an accessory pathway called the James fiber that bypasses the atrioventricular node, shortening the PR interval without widening the QRS complex or producing a delta wave. It differs from Wolff-Parkinson-White Syndrome in that the accessory pathway is intranodal rather than a direct connection between the atria and ventricles, so ventricular conduction occurs through the normal pathways without early ventricular activation. The key criteria for Lown-Ganong-Levine Syndrome are a shortened PR interval under 0.12 seconds, normal QRS width, and absence of a delta wave.

Intracardiac ElectrogramsTaiwan Heart Rhythm Society

The document discusses intracardiac electrograms (IEGMs) and catheter positions used in electrophysiology studies. It provides information on unipolar and bipolar recordings, including how bipolar signals are constructed and how they approximate the rate of change of the cardiac wavefront. The document also discusses how the direction of cardiac activation influences the electrocardiogram and how unipolar and bipolar recordings compare. Key factors that influence electrogram morphology such as conduction speed, myocardial mass, and tissue characteristics are also reviewed.

Electrophysiology basics,part1(lecture)salah_atta

This document provides information about electrophysiologic studies (EPS), including the purpose, requirements, procedures, and how to read EPS tracings. An EPS involves placing electrode catheters in the heart to record electrical activity, stimulate heart tissues, and induce/evaluate arrhythmias. Key aspects of an EPS include determining the sequence of impulse propagation in different heart areas during normal sinus rhythm, pacing, and induced rhythms to diagnose arrhythmias.

Basic EP StudyMaruli Butarbutar

An electrophysiology study involves placing electrode catheters in the heart to assess conduction and induce arrhythmias. It can evaluate conditions like supraventricular tachycardia, ventricular tachycardia, sinus node dysfunction, and conduction abnormalities. The study assesses basic intervals, sinus node function, refractory periods, and the response to atrial and ventricular extra stimuli pacing to determine appropriate therapy. Complications may include vascular or cardiac issues, but the study provides important information to guide treatment of arrhythmias.

ECG ARTIFACTS AND PITFALLS Padmanabh Kamath

This document discusses ECG artifacts and pitfalls in interpretation. It outlines 10 commandments for proper ECG acquisition to avoid artifacts. Artifacts are classified as internal (physiological) or external (non-physiological). Common artifacts include limb and precordial lead reversals, tremor artifact, computer averaging errors, and electromagnetic interference. Differentiating artifacts from true arrhythmias like ventricular tachycardia is important. Characteristics that can help differentiate include absence of hemodynamic effects, normal complexes within the artifact, and association with movement. Proper electrode placement and equipment grounding can help reduce artifact occurrence.

Regional anaesthesia and antithromboticChamika Huruggamuwa

This document discusses regional anesthesia and antithrombotic drugs. It notes that vertebral canal hematoma is a rare but potentially devastating complication of central neuraxial blockade, especially for patients taking anticoagulant or antithrombotic drugs. It provides guidance on timing the administration of various antithrombotic drugs like aspirin, clopidogrel, enoxaparin and warfarin in relation to regional anesthesia to minimize bleeding risks. It also discusses risk factors and considerations for different types of regional techniques and antithrombotic drugs.

Advances in neuro anesthesia monitoringWesam Mousa

The document discusses various techniques for monitoring the brain during anesthesia to prevent neurological insults. It describes electroencephalography (EEG) techniques like raw EEG, bispectral index, and entropy which can detect cerebral ischemia. It also discusses evoked potentials like somatosensory evoked potentials (SSEPs) and motor evoked potentials (MEPs) using electrical stimulation to assess spinal cord and brain function. Additional monitoring methods covered are intracranial pressure (ICP), cerebral blood flow (CBF), brain oxygenation, and electromyography (EMG) for nerve function. The document emphasizes multimodal monitoring as the gold standard to reduce intraoperative neurological injury.

marcapasos en biomedicaGustavo Alfaro

El documento describe los marcapasos, dispositivos médicos que ayudan a regular el ritmo cardíaco. Los marcapasos contienen un generador de impulsos con batería y electrodos que se implantan quirúrgicamente en el corazón. Detectan el ritmo cardíaco y envían impulsos eléctricos para estimular contracciones rítmicas cuando la frecuencia es demasiado lenta. Se usan para tratar ritmos cardíacos irregulares o lentos y deben revisarse periódicamente para monitorear su funcionamiento y re

Cardiac arrhythmia and anti arrhythmic drugsArslan Maqsood

This document provides an overview of cardiac arrhythmias and anti-arrhythmic drugs. It discusses the electrophysiology of normal heart rhythm, heart automaticity and action potentials, causes of cardiac arrhythmias, types of cardiac arrhythmias including those originating from the atria, AV node, and ventricles. It also covers how the parasympathetic and sympathetic nervous systems control heart rhythm and the classification of anti-arrhythmic drugs.

Patients with pacemaker anaesthetic implicationsGowri Shankar

This document provides information on cardiac implanted electronic devices (CIEDs) such as pacemakers and implantable cardioverter defibrillators (ICDs). It discusses the basics of CIED functions, indications for use, and anesthetic management in the preoperative, intraoperative and postoperative periods. Special considerations for CIED patients include monitoring, preventing device malfunction from electrosurgery or other sources, and having temporary pacing equipment available.

Manejo actualizado del Estatus epileptico.pptxssuserb6929e

Este documento trata sobre el estatus epiléptico. Define el estatus epiléptico como convulsiones continuas o repetitivas que duran más de 5 minutos. Describe la fisiopatología, diagnóstico, tratamiento y pronóstico del estatus epiléptico. El tratamiento incluye medicamentos antiepilépticos de primera y segunda línea, así como anestésicos y otras opciones para casos refractarios o super refractarios.

Primary PCIPERKI Pekanbaru

Ishemic heart diseasegaurav gogoi

CEREBRAL ARTERIO VENOUS MALFORMATIONS SHAMEEJ MUHAMED KV

This document provides an overview of cerebral arteriovenous malformations (AVMs). It defines a cerebral AVM as a vascular malformation with direct connections between arteries and veins, without an intervening capillary bed. The key characteristics of AVMs are described, including their demographics, clinical presentations such as hemorrhage and seizures, evaluation with imaging and angiography, grading systems like the Spetzler-Martin scale, and treatment options including surgery, embolization, and radiosurgery. Guidelines for treatment are outlined based on the grade of the AVM, with lower grade AVMs more amenable to aggressive treatment aiming for cure.

心臟植入性电子仪器(颁滨贰顿)的基本原理及设定Taiwan Heart Rhythm Society

1. The document discusses the basic principles and settings of cardiovascular implantable electronic devices (CIEDs), including pacemakers. 2. It covers topics such as pacing and sensing functions, parameters like lower and upper rates, pacing modes, and refractory and blanking periods. 3. The optimal settings aim to ensure cardiac pacing meets patients' needs while avoiding unnecessary pacing and maximizing battery longevity.

207&356 moya moya &adult moyamoya diseaseNeurosurgery Vajira

Moyamoya disease (MMD) is a rare, chronic occlusive cerebrovascular disease where the arteries at the base of the brain become narrowed and obstructed. In adults, MMD commonly presents with cerebral hemorrhage, while in children it typically causes cerebral ischemia. The pathology of MMD involves fibrocellular thickening of the intimal layer and disruption of the internal elastic lamina of vessels. Surgical treatment aims to augment blood flow by direct or indirect revascularization techniques such as superficial temporal artery to middle cerebral artery bypass or encephaloduroarteriosynangiosis. Preoperative management focuses on stabilizing clinical symptoms and optimizing patient hemodynamics prior to surgery.

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