Neurologic Complications in the Intensive Care Unit

Neurology of Systemic Diseases (J Biller, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Neurology of Systemic Disease

Abstract

Complications involving the central and peripheral nervous system are frequently encountered in critically ill patients. All components of the neuraxis can be involved including the brain, spinal cord, peripheral nerves, neuromuscular junction, and muscles. Neurologic complications adversely impact outcome and length of stay. These complications can be related to underlying critical illness, pre-existing comorbid conditions, and commonly used and life-saving procedures and medications. Familiarity with the myriad neurologic complications that occur in the intensive care unit can facilitate their timely recognition and treatment. Additionally, awareness of treatment-related neurologic complications may inform decision-making, mitigate risk, and improve outcomes.

Keywords

Toxic metabolic encephalopathy Anoxic brain injury Stroke Seizures Critical illness myopathy Critical illness neuropathy Posttraumatic stress disorder 

Notes

Compliance with Ethical Standards

Conflict of Interest

Clio Rubinos and Sean Ruland declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. 1.
    Bleck T, Smith M, Pierre-Louis S, Jares JJ, Murray J. Neurologic complications of critical medical illness. Crit Care Med. 1993;21:98–103.PubMedCrossRefGoogle Scholar
  2. 2.
    Plum F, Posner J. The diagnosis of stupor and coma. New York: Oxford University Press; 1981.Google Scholar
  3. 3.
    Teasdale G, Jennet B. Assessment of coma and impaired consciousness. A practical scale. Lancet. 1974;2(7872):81–4.PubMedCrossRefGoogle Scholar
  4. 4.
    Wijdicks EFM, Bamlet WR, Maramattom BV, et al. Validation of a new coma scale: the FOUR score. Ann Neurol. 2005;58(4):585–93.PubMedCrossRefGoogle Scholar
  5. 5.
    Boeson MB, Hranchook A, Stoller J. Peripheral nerve injury from intravenous cannulation: a case report. AANA J. 2000;68(1):53–7.PubMedGoogle Scholar
  6. 6.
    Ramos JA. Venipuncture-related lateral antebrachial cutaneous nerve injury: what to know? Brazilian J Anesthesiol (English Ed). 2014;64(2):131–3.Google Scholar
  7. 7.
    Horowitz SH. Peripheral nerve injury and causalgia secondary to routine venipuncture. Neurology. 1994;44(5):962–4.PubMedCrossRefGoogle Scholar
  8. 8.
    Fishman JM. Recurrent laryngeal nerve palsy complicating subclavian line insertion: a case report. J Med Case Rep. 2009;3:9034.PubMedPubMedCentralCrossRefGoogle Scholar
  9. 9.
    Macon WL, Futrell JW. Median-nerve neuropathy after percutaneous puncture of the brachial artery in patients receiving anticoagulants. N Engl J Med. 1973;288(26):1396.PubMedCrossRefGoogle Scholar
  10. 10.
    Briscoe CE, Bushman JA, McDonald WI. Extensive neurological damage after cannulation of internal jugular vein. Br Med J. 1974;1(5903):314.PubMedPubMedCentralCrossRefGoogle Scholar
  11. 11.
    Defalque RJ, Fletcher MV. Neurological complications of central venous cannulation. Jpen J Parenter Enter Nutr. 1988;12(4):406–9.CrossRefGoogle Scholar
  12. 12.
    Thomas S, Bhandari V. Nerve plexus injury with internal jugular cannulation. Indian J Anaesth. 2004;48(3):228–30.Google Scholar
  13. 13.
    Ahn EJ, Baek CW, Shin HY, Kang H, Jung YH. Phrenic nerve palsy after internal jugular venous catheter placement. Korean J Anesthesiol. 2012;63(2):183–4.PubMedPubMedCentralCrossRefGoogle Scholar
  14. 14.
    Ho KM, Lim H. Femoral nerve palsy: an unusual complication after femoral vein puncture in a patient with severe coagulopathy. Anesth Analg. 1999;89(3):672–3.PubMedGoogle Scholar
  15. 15.
    Heckmann JG, Lang C, Kindler K, et al. Neurologic manifestations of cerebral air embolism as a complication of central venous catheterization. Crit Care Med. 2000;28(5):1621–5.PubMedCrossRefGoogle Scholar
  16. 16.
    Naik-Tolani S, Oropello JM, Benjamin E. Neurologic complications in the intensive care unit. Clin Chest Med. 1999;20(2):423–34.PubMedCrossRefGoogle Scholar
  17. 17.
    Gursoy S, Duger K, Kaygusuz K, et al. Cerebral arterial air embolism associated with mechanical ventilation and deep tracheal aspiration. Case Rep Pulmonol. 2012;2012:416360.PubMedPubMedCentralGoogle Scholar
  18. 18.
    Blanc P, Boussuges A, Henriette K, Sainty JM, et al. Iatrogenic cerebral air embolism: importance of an early hyperbaric oxygenation. Intensive Care Med. 2002;28(5):559–63.PubMedCrossRefGoogle Scholar
  19. 19.
    Cruz-Flores S, Diamond AL, Leira EC. Cerebral air embolism secondary to intra-aortic balloon pump rupture. Neurocrit Care. 2005;2(1):49–50.PubMedCrossRefGoogle Scholar
  20. 20.
    Shaw A, Cooperman A, Fusco J. Gas embolism produced by hydrogen peroxide. N Engl J Med. 1967;277(5):238–41.PubMedCrossRefGoogle Scholar
  21. 21.
    Holloway KL, Barnes T, Choi S, et al. Ventriculostomy infections: the effect of monitoring duration and catheter exchange in 584 patients. J Neurosurg. 1996;85(3):419–24.PubMedCrossRefGoogle Scholar
  22. 22.
    Bekar A, Doğan S, Abaş F, et al. Risk factors and complications of intracranial pressure monitoring with a fiberoptic device. J Clin Neurosci. 2009;16(2):236–40.PubMedCrossRefGoogle Scholar
  23. 23.
    Rebuck JA, Murry KR, Rhoney DH, Michael DB, Coplin WM. Infection related to intracranial pressure monitors in adults: analysis of risk factors and antibiotic prophylaxis. J Neurol Neurosurg Psychiatry. 2000;69(3):69. 381–384.CrossRefGoogle Scholar
  24. 24.•
    Wright BLC, Lai JTF, Sinclair AJ. Cerebrospinal fluid and lumbar puncture: a practical review. J Neurol. 2012;259(8):1530–45. A comprehensive review of the physiology and analysis of cerebrospinal fluid, lumbar puncture indications, and technique.PubMedCrossRefGoogle Scholar
  25. 25.
    Hillemacher T, Bleich S, Witfang J, et al. Should aspirin be discontinued for diagnostic lumbar puncture? J Am Geriatr Soc. 2006;54(1):181–2.PubMedCrossRefGoogle Scholar
  26. 26.
    Layton KF, Kallmes DF, Horlocker TT. Recommendations for anticoagulated patients undergoing image-guided spinal procedures. Am J Neuroradiol. 2006;27(3):468–70.PubMedGoogle Scholar
  27. 27.
    AçIkbaş SC, Akyüz M, Kazan S, Tuncer R. Complications of closed continuous lumbar drainage of cerebrospinal fluid. Acta Neurochir (Wien). 2002;144(5):475–48.CrossRefGoogle Scholar
  28. 28.
    Scherer R, Schmutzler M, Giebler R, et al. Complications related to thoracic epidural analgesia: a prospective study in 1071 surgical patients. Acta Anaesthesiol Scand. 1993;37(4):370–4.PubMedCrossRefGoogle Scholar
  29. 29.
    Piccioni F, Bernardelli SL, Casiraghi C, Langer M. Minor complications during thoracic epidural catheter placement. Eur J Anaesthesiol. 2015;32(7):512–3.PubMedCrossRefGoogle Scholar
  30. 30.
    Yan K, Diggan MF. A case of central cord syndrome caused by intubation: a case report. J Spinal Cord Med. 1997;20(2):230–2.PubMedCrossRefGoogle Scholar
  31. 31.
    Oppenlander ME, Hsu FD, Bolton P, Theodore N. Catastrophic neurological complications of emergent endotracheal intubation: report of 2 cases. J Neurosurg Spine. 2015;22(5):454–8.PubMedCrossRefGoogle Scholar
  32. 32.
    Evers KA, Eindhoven GB, Wierda JM. Transient nerve damage following intubation for trans-sphenoidal hypophysectomy. Can J Anaesth. 1999;46(12):1143–5.PubMedCrossRefGoogle Scholar
  33. 33.
    Cavo JW. True vocal cord paralysis following intubation. Laryngoscope. 1985;172(2):991–3.Google Scholar
  34. 34.
    Shin YH, An DA, Choi WJ, Kim YH. Unilateral vocal cord paralysis following a short period of endotracheal intubation anesthesia. Korean J Anesthesiol. 2013;65(5):357–8.PubMedPubMedCentralCrossRefGoogle Scholar
  35. 35.
    Barlas I, Oropello JM, Benjamin E. Neurologic complications in intensive care. Curr Opin Crit Care. 2001;7(2):68–73.PubMedCrossRefGoogle Scholar
  36. 36.
    McGuire G, Crossley D, Richards J, Wong D. Effects of varying levels of positive end-expiratory pressure on intracranial pressure and cerebral perfusion pressure. Crit Care Med. 1997;25(6):1059–62.PubMedCrossRefGoogle Scholar
  37. 37.
    Muench E, Bauhuf C, Roth H, et al. Effects of positive end-expiratory pressure on regional cerebral blood flow, intracranial pressure, and brain tissue oxygenation. Crit Care Med. 2005;33(1):2367–72.PubMedCrossRefGoogle Scholar
  38. 38.
    Caricato A, Conti G, Della Corte F, et al. Effects of PEEP on the intracranial system of patients with head injury and subarachnoid hemorrhage: the role of respiratory system compliance. J Trauma. 2005;58(3):571–6.PubMedCrossRefGoogle Scholar
  39. 39.
    Georgiadis D, Schwarz S, Baumgartner RW, et al. Influence of positive end-expiratory pressure on intracranial pressure and cerebral perfusion pressure in patients with acute stroke. Stroke. 2001;32(9):2088–92.PubMedCrossRefGoogle Scholar
  40. 40.
    Stringer WA, Hasso AN, Thompson JR, et al. Hyperventilation-induced cerebral ischemia in patients with acute brain lesions: demonstration by xenon-enhanced CT. AJNR Am J Neuroradiol. 1993;14(2):475–84.PubMedGoogle Scholar
  41. 41.
    Soustiel JF, Mahamid E, Chistyakov A, et al. Comparison of moderate hyperventilation and mannitol for control of intracranial pressure control in patients with severe traumatic brain injury—a study of cerebral blood flow and metabolism. Acta Neurochir (Wien). 2006;148(8):845–51.CrossRefGoogle Scholar
  42. 42.
    Bricker MB, Morris WP, Allen SJ, et al. Venous air embolism in patients with pulmonary barotrauma. Crit Care Med. 1994;22(1):1692–8.PubMedCrossRefGoogle Scholar
  43. 43.•
    Nasr D, Rabinstein A. Neurologic complications of extracorporeal membrane oxygenation. J Clin Neurol. 2015;11(4):383–9. A large retrospective study of 23,951 patients that investigated outcomes and neurologic complication of extracorporeal membrane oxygenation.PubMedPubMedCentralCrossRefGoogle Scholar
  44. 44.
    Mateen FJ, Muralidharan R, Shinohara RT, et al. Neurological injury in adults treated with extracorporeal membrane oxygenation. Arch Neurol. 2011;68(12):1543–9.PubMedCrossRefGoogle Scholar
  45. 45.
    Kakkar R, Ellis M, Fearon PV. Compartment syndrome of the thigh as a complication of anticoagulant therapy in a patient with a left ventricular assist device (Berlin Heart). Gen Thorac Cardiovasc Surg. 2010;58(9):477–9.PubMedCrossRefGoogle Scholar
  46. 46.•
    Frontera JA. Metabolic encephalopathies in the critical care unit. Contin Lifelong Learn Neurol. 2012;18(3):611–39. A comprehensive overview of common etiologies of metabolic encephalopathy and the approach to its management. The article also included cases and tables that highlight key points in evaluation, diagnosis and management.CrossRefGoogle Scholar
  47. 47.
    Kennedy AC, Linton AL, Eaton JC. Urea levels in cerebrospinal fluid after haemodialysis. Lancet. 1962;1(7226):410–1.PubMedCrossRefGoogle Scholar
  48. 48.
    Patel N, Dalal P, Panesar M. Dialysis disequilibrium syndrome: a narrative review. Semin Dial. 2008;21(5):493–8.PubMedCrossRefGoogle Scholar
  49. 49.
    Deepa C, Muralidhar K. Renal replacement therapy in ICU. J Anaesthesiol Clin Pharmacol. 2012;28(3):386–96.PubMedPubMedCentralCrossRefGoogle Scholar
  50. 50.•
    Kato TS, Schulze PC, Yang J, et al. Pre-operative and post-operative risk factors associated with neurologic complications in patients with advanced heart failure supported by a left ventricular assist device. J Hear Lung Transplant. 2012;31(1):1–8. A retrospective study of 307 patients that underwent LVAD surgery showing previous stroke, malnutrition and heart failure severity as predisposing pre-operative risk factors for neurological complications.CrossRefGoogle Scholar
  51. 51.
    Shuhaiber JH, Jenkins D, Berman M, et al. The Papworth experience with the Levitronix CentriMag ventricular assist device. J Heart Lung Transplant. 2008;27(2):158–64.PubMedCrossRefGoogle Scholar
  52. 52.
    Thomas CE, Jichici D, Petrucci R, et al. Neurologic complications of the Novacor left ventricular assist device. Ann Thorac Surg. 2001;72(4):1311–5.PubMedCrossRefGoogle Scholar
  53. 53.
    Wiis J, Qvist J. Peroneal nerve paresis after long-term bed rest in intensive care patients. Ugeskr Laeger. 1999;161(33):4641–2.PubMedGoogle Scholar
  54. 54.
    Sahathevan R, Hamidon B, Maniam T, Raymond A. Peripheral neuropathy secondary to traction injury resulting from the use of physical restraints. Neurol Asia. 2012;15(3):267–9.Google Scholar
  55. 55.
    Parissis H, Soo A, Al-Alao B. Intra aortic balloon pump: literature review of risk factors related to complications of the intraaortic balloon pump. J Cardiothorac Surg. 2011;6:147.PubMedPubMedCentralCrossRefGoogle Scholar
  56. 56.
    Hazelrigg SR, Auer JE, Seifert PE. Experience in 100 transthoracic balloon pumps. Ann Thorac Surg. 1992;54(3):528–32.PubMedCrossRefGoogle Scholar
  57. 57.
    Ho ACY, Hong C, Yang M, Lu P, Lin P. Stroke after intraaortic balloon counterpulsation associated with mobile atheroma in thoracic aorta diagnosed using transesophageal echocardiography. Chang Gung Med J. 2002;25(9):612–6.PubMedGoogle Scholar
  58. 58.
    Honet J, Wajszczuk W, Rubenfire M, Kantrowitz A. Neurological abnormalities in the leg(s) after use of intraaortic balloon pump: report of six cases. Arch Phys Med Rehabil. 1975;56(8):346–52.PubMedGoogle Scholar
  59. 59.
    McCabe JC, Abel RM, Subramanian VA, Guy WA. Complications of intra-aortic balloon insertion and counterpulsation. Circulation. 1978;57(4):769–73.PubMedCrossRefGoogle Scholar
  60. 60.
    Singh BM, Fass AE, Pooley RW, Wallach R. Paraplegia associated with intraaortic balloon pump counterpulsation. Stroke. 1983;14(6):983–6.PubMedCrossRefGoogle Scholar
  61. 61.
    Spronk PE, Riekerk B, Hofhuis J, Rommes JH. Occurrence of delirium is severely underestimated in the ICU during daily care. Intensive Care Med. 2009;35(7):1276–80.PubMedPubMedCentralCrossRefGoogle Scholar
  62. 62.
    Razvi SSM, Bone I. Neurological consultations in the medical intensive care unit. J Neurol Neurosurg Psychiatry. 2003;74 Suppl 3:iii16–23.PubMedPubMedCentralGoogle Scholar
  63. 63.
    Witlox J, Eurelings LS, de Jonghe JF, et al. Delirium in elderly patients and the risk of postdischarge mortality. JAMA. 2012;304(4):443–51.CrossRefGoogle Scholar
  64. 64.
    Ely EW, Inouye SK, Bernard GR, et al. Delirium in mechanically ventilated patients validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU). JAMA. 2001;286(21):2703–10.PubMedCrossRefGoogle Scholar
  65. 65.
    Bergeron N, Dubois M-J, Dumont M, Dial S, Skrobik Y. Intensive Care Delirium Screening Checklist: evaluation of a new screening tool. Intensive Care Med. 2001;27(5):859–64.PubMedCrossRefGoogle Scholar
  66. 66.
    Riggs JE. Neurologic manifestations of electrolyte disturbances. Neurol Clin. 2002;20(1):227–39. vii.PubMedCrossRefGoogle Scholar
  67. 67.
    Yee AH, Rabinstein AA. Neurologic presentations of acid-base imbalance, electrolyte abnormalities, and endocrine emergencies. Neurol Clin. 2012;28(1):1–16.CrossRefGoogle Scholar
  68. 68.
    Kumar N. Neurologic presentations of nutritional deficiencies. Neurol Clin. 2012;28(1):107–70.CrossRefGoogle Scholar
  69. 69.
    Zuccoli G et al. MR imaging findings in 56 patients with Wernicke encephalopathy: nonalcoholics may differ from alcoholics. Am J Neuroradiol. 2009;30(1):171–6.PubMedCrossRefGoogle Scholar
  70. 70.
    Caine D, Halliday GM, Kril JJ, Harper CG. Operational criteria for the classification of chronic alcoholics: identification of Wernicke’s encephalopathy. J Neurol Neurosurg Psychiatry. 1997;62(1):51–60.PubMedPubMedCentralCrossRefGoogle Scholar
  71. 71.
    Venkatram S, Chilimuri S, Adrish M, et al. Vitamin D deficiency is associated with mortality in the medical intensive care unit. Crit Care. 2011;15(6):R292.PubMedPubMedCentralCrossRefGoogle Scholar
  72. 72.
    Adrogué HJ, Madias NE. Management of life-threatening acid-base disorders. First of two parts. N Engl J Med. 1998;338(1):26–34.PubMedCrossRefGoogle Scholar
  73. 73.
    Abdel-Motleb M. The neuropsychiatric aspect of Addison’s disease: a case report. Innov Clin Neurosci. 2012;9(10):34–6.PubMedPubMedCentralGoogle Scholar
  74. 74.•
    Ishii M. Neurologic complications of nondiabetic endocrine disorders. Contin Lifelong Learn Neurol. 2014;20(3 Neurology of Systemic Disease):560–79. Detailed review of neurologic complications from endocrine disorders highlighting clinical findings and etiologies.CrossRefGoogle Scholar
  75. 75.
    Young GB. Neurologic complications of systemic critical illness. Neurol Clin. 1995;13(3):645–58.PubMedGoogle Scholar
  76. 76.•
    Alberto San Román J, Vilacosta I. Neurological complications in infective endocarditis. Eur Heart J. 2012;34(45):3467–8a. A summary of neurological complications in infective endocarditis patients and the challenges of surgical treatment.Google Scholar
  77. 77.
    Bolton CF, Young GB, Zochodne DW. The neurological complications of sepsis. Ann Neurol. 1993;33(1):94–100.PubMedCrossRefGoogle Scholar
  78. 78.•
    Hocker S, Wijdicks EFM. Neurologic complications of sepsis. Continuum (Minneap Minn). 2012;20(3 Neurology of Systemic Disease):598–613. A comprehensive review of evaluation, diagnosis and treatment of neurologic complications of sepsis.Google Scholar
  79. 79.
    Oddo M, Carrera E, Claassen J, Mayer SA, Hirsch LJ. Continuous electroencephalography in the medical intensive care unit. Crit Care Med. 2009;37(6):2051–6.PubMedCrossRefGoogle Scholar
  80. 80.
    Young G, Bolton C, Archibald Y, Austin T, Wells G. The electroencephalogram in sepsis-associated encephalopathy. J Clin Neurophysiol. 1992;9(1):145–52.PubMedCrossRefGoogle Scholar
  81. 81.
    Sharma P, Eesa M, Scott JN. Toxic and acquired metabolic encephalopathies: MRI appearance. Am J Roentgenol. 2009;193(3):879–86.CrossRefGoogle Scholar
  82. 82.
    Corcoran TB, O’Neill MA, Webb SAR, Ho KM. Prevalence of vitamin deficiencies on admission: relationship to hospital mortality in critically ill patients. Anaesth Intensive Care. 2009;37(2):254–60.PubMedGoogle Scholar
  83. 83.•
    Klubo-Gwiezdzinska J, Wartofsky L. Thyroid emergencies. Med Clin North Am. 2012;96(2):385–403. An important reference that covers epidemiology, etiologies, clinical signs and symptoms, treatment and prognosis of thyroid emergencies.PubMedCrossRefGoogle Scholar
  84. 84.
    Mistry N, Wass J, Turner MR. When to consider thyroid dysfunction in the neurology clinic. Pract Neurol. 2009;9(3):145–56.PubMedCrossRefGoogle Scholar
  85. 85.
    Boddu NJ, Badireddi S, Straub KD, et al. Acute thyrotoxic bulbar myopathy with encephalopathic behaviour: an uncommon complication of hyperthyroidism. Case Rep Endocrinol. 2013;2013:369807.PubMedPubMedCentralGoogle Scholar
  86. 86.
    Song T-J, Kim S-J, Kim GS, et al. The prevalence of thyrotoxicosis-related seizures. Thyroid. 2010;20(9):955–8.PubMedCrossRefGoogle Scholar
  87. 87.
    Khatri M, Wright CB, Nickolas TL, et al. Chronic kidney disease is associated with white matter hyperintensity volume: the Northern Manhattan Study (NOMAS). Stroke. 2007;38(12):3121–6.PubMedPubMedCentralCrossRefGoogle Scholar
  88. 88.
    Kumar G, Goyal MK. Lentiform fork sign: a unique MRI picture. Is metabolic acidosis responsible? Clin Neurol Neurosurg. 2010;112:805–12.PubMedCrossRefGoogle Scholar
  89. 89.
    Albrecht J, Norenberg MD. Glutamine: a Trojan horse in ammonia neurotoxicity. Hepatology. 2006;44(4):788–94.PubMedCrossRefGoogle Scholar
  90. 90.
    Voils SA, Human T, Brophy GM. Adverse neurologic effects of medications commonly used in the intensive care unit. Crit Care Clin. 2014;30(4):795–811.PubMedCrossRefGoogle Scholar
  91. 91.
    Wills B, Erickson T. Chemically induced seizures. Clin Lab Med. 2006;26:185–209. ix.PubMedCrossRefGoogle Scholar
  92. 92.
    Grosset KA, Grosset DG. Prescribed drugs and neurological complications. J Neurol Neurosurg Psychiatry. 2004;75 Suppl 3:iii2–i8.PubMedPubMedCentralGoogle Scholar
  93. 93.•
    Karceski S. Acute symptomatic seizures and systemic illness. Contin Lifelong Learn Neurol. 2014;20(3 Neurology of Systemic Disease):614–23. A detailed review of medical causes of acute symptomatic seizures.CrossRefGoogle Scholar
  94. 94.
    Sullivan JT, Sykora K, Schneiderman J, et al. Assessment of alcohol withdrawal: the revised Clinical Institute Withdrawal Assessment for Alcohol scale (CIWA-Ar). Br J Addict. 1989;84(11):1353–7.PubMedCrossRefGoogle Scholar
  95. 95.
    Khantzian EJ, McKenna GJ. Acute toxic and withdrawal reactions associated with drug use and abuse. Ann Intern Med. 1979;90(3):361–72.PubMedCrossRefGoogle Scholar
  96. 96.
    Grill MF, Maganti RK. Neurotoxic effects associated with antibiotic use: management considerations. Br J Clin Pharmacol. 2011;72(3):381–93.PubMedPubMedCentralCrossRefGoogle Scholar
  97. 97.
    Duquaine S, Kitchell E, Tate T, et al. Central nervous system toxicity associated with ertapenem use. Ann Pharmacother. 2011;45(1):e6.PubMedCrossRefGoogle Scholar
  98. 98.•
    Fugate JE, Kalimullah EA, Hocker SE, et al. Cefepime neurotoxicity in the intensive care unit: a cause of severe, underappreciated encephalopathy. Crit Care. 2013;17(6):R264. A retrospective study of adult ICU patients that had neurotoxicity after the initiation of cefepime therapy. Myoclonus, seizures and encephalopathy were the main clinical manifestation.PubMedPubMedCentralCrossRefGoogle Scholar
  99. 99.
    Jallon P, Fankhauser L, Du Pasquier R, et al. Severe but reversible encephalopathy associated with cefepime. Neurophysiol Clin. 2000;30(6):383–6.PubMedCrossRefGoogle Scholar
  100. 100.
    Kim E, Na DG, Kim EY, et al. MR imaging of metronidazole-induced encephalopathy: lesion distribution and diffusion-weighted imaging findings. Am J Neuroradiol. 2007;28(9):1652–8.PubMedCrossRefGoogle Scholar
  101. 101.
    Brooks DE, Levine M, O’Connor AD, et al. Toxicology in the ICU. Part 2: specific toxins. Chest. 2011;140(4):1072–785.PubMedCrossRefGoogle Scholar
  102. 102.
    Karim A, Ahmed S, Siddiqui R, Mattana J. Methemoglobinemia complicating topical lidocaine used during endoscopic procedures. Am J Med. 2001;111(2):150–3.PubMedCrossRefGoogle Scholar
  103. 103.
    Kwok S, Fischer JL, Rogers JD. Benzocaine and lidocaine induced methemoglobinemia after bronchoscopy: a case report. J Med Case Rep. 2008;2:16.PubMedPubMedCentralCrossRefGoogle Scholar
  104. 104.
    Tsang W, Houlden RL. Amiodarone-induced thyrotoxicosis: a review. Can J Cardiol. 2009;25(7):421–4.PubMedPubMedCentralCrossRefGoogle Scholar
  105. 105.
    Polsonetti BW, Joy SD, Laos LF. Steroid-induced myopathy in the ICU. Ann Pharmacother. 2002;36(11):1741–4.PubMedCrossRefGoogle Scholar
  106. 106.•
    De Loecker I, Preiser J-C. Statins in the critically ill. Ann Intensive Care. 2012;2(1):19. A review of statin mechanism of action including anti-inflammatory, immunomodulatory, antioxidant and antithrombotic effects. The clinical effects of statin use in ICU conditions such as ALI, ARDS, and sepsis is described.PubMedPubMedCentralCrossRefGoogle Scholar
  107. 107.•
    Barr J, Fraser GL, Puntillo K, et al. Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit. Crit Care Med. 2013;41(1):263–306. Guidelines for the treatment and prevention of pain, agitation and delirium.PubMedCrossRefGoogle Scholar
  108. 108.
    Jacobi J, Fraser GL, Coursin DB, et al. Clinical practice guidelines for the sustained use of sedatives and analgesics in the critically ill adult. Crit Care Med. 2002;30(1):119–41.PubMedCrossRefGoogle Scholar
  109. 109.•
    Bouwes A, van Poppelen D, Koelman JH, et al. Acute posthypoxic myoclonus after cardiopulmonary resuscitation. BMC Neurol. 2012;12:63. A prospective study of 391 ICU patients post CPR that showed cortical and subcortical origin of myoclonus correlating with poor outcome.PubMedPubMedCentralCrossRefGoogle Scholar
  110. 110.
    Wijdicks EFM, Sharbrough F. New-onset seizures in critically ill patients. Neurology. 1993;43(5):1042–4.PubMedCrossRefGoogle Scholar
  111. 111.
    Claassen J, Mayer S, Kowalski RG, et al. Detection of electrographic seizures with continuous EEG monitoring in critically ill patients. Neurology. 2004;62(10):1743–8.PubMedCrossRefGoogle Scholar
  112. 112.
    Towne A, Waterhouse EJ, Boggs JG, et al. Prevalence of nonconvulsive status epilepticus in comatose patients. Neurology. 2000;54(2):340–5.PubMedCrossRefGoogle Scholar
  113. 113.
    Laver S, Farrow C, Turner D, Nolan J. Mode of death after admission to an intensive care unit following cardiac arrest. Intensive Care Med. 2004;30(11):2126–8.PubMedCrossRefGoogle Scholar
  114. 114.
    Wijdicks EFM, Hijdra A, Young GB, et al. Practice parameter: prediction of outcome in comatose survivors after cardiopulmonary resuscitation (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2006;67(2):203–10.PubMedCrossRefGoogle Scholar
  115. 115.
    Travers AH, Rea TD, Bobrow BJ, et al. Part 4: CPR overview: 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2010;122(18 Suppl 3):S676–84.PubMedCrossRefGoogle Scholar
  116. 116.•
    Kamps MJ, Horn J, Oddo M, et al. Prognostication of neurologic outcome in cardiac arrest patients after mild therapeutic hypothermia: a meta-analysis of the current literature. Intensive Care Med. 2013;39:1671–82. A meta-analysis reviewing current data about neurological examination and somatosensory evoked potential as prognostic tools in patients post-CPR followed by therapeutic hypothermia.PubMedCrossRefGoogle Scholar
  117. 117.
    Levine RL, LeClerc JR, Bailey JE, et al. Venous and arterial thromboembolism in severe sepsis. Thromb Haemost. 2008;99(5):892–9.PubMedGoogle Scholar
  118. 118.
    Wijdicks EFM, Scott JP. Stroke in the medical intensive-care unit. Mayo Clin Proc. 1998;73(7):642–6.PubMedCrossRefGoogle Scholar
  119. 119.
    Pilato F, Profice P, Dileone M, et al. Stroke in critically ill patients. Minerva Anestesiol. 2009;75(5):245–50.PubMedGoogle Scholar
  120. 120.
    Walkey AJ, Wiener RS, Ghobrial JM, et al. Incident stroke and mortality associated with new-onset atrial fibrillation in patients hospitalized with severe sepsis. JAMA. 2011;306(20):2248–54.PubMedPubMedCentralCrossRefGoogle Scholar
  121. 121.
    Vadmann H, Nielsen PB, Hjortshøj S/P, et al. Atrial flutter and thromboembolic risk: a systematic review. Heart. 2015;101(18):1446–55.PubMedCrossRefGoogle Scholar
  122. 122.•
    January CT, Wann LS, Alpert JS, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the Heart Rhythm Society. Circulation. 2014;130(23):2071–104. Guideline for the management of atrial fibrillation reviewing pathophysiology, risk factors, clinical evaluation, thromboembolic risk and treatment.PubMedCrossRefGoogle Scholar
  123. 123.
    Nagarakanti R, Ezekowitz M, Oldgren J, et al. Dabigatran versus warfarin in patients with atrial fibrillation: an analysis of patients undergoing cardioversion. Circulation. 2011;123(2):131–6.PubMedCrossRefGoogle Scholar
  124. 124.
    Piccini JP, Stevenns S, Lokhnygina Y, et al. Outcomes after cardioversion and atrial fibrillation ablation in patients treated with rivaroxaban and warfarin in the ROCKET AF trial. J Am Coll Cardiol. 2013;61(19):1998–2006.PubMedCrossRefGoogle Scholar
  125. 125.
    Flaker G, Lopes R, Alkhatib S, et al. Efficacy and safety of apixaban in patients after cardioversion for atrial fibrillation: insights from the ARISTOTLE Trial (Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation). J Am Coll Cardiol. 2014;63(11):1082–7.PubMedCrossRefGoogle Scholar
  126. 126.
    Cappato R, Ezekowitz M, Klein A, et al. Rivaroxaban vs. vitamin K antagonists for cardioversion in atrial fibrillation. Eur Heart J. 2014;35(47):3346–55.PubMedCrossRefGoogle Scholar
  127. 127.•
    Finsterer J, Stöllberger C, Wahbi K. Cardiomyopathy in neurological disorders. Cardiovasc Pathol. 2013;22(5):389–400. A detailed review of cardiomyopathy with emphasis on secondary cardiomyopathy and the most frequent neurological complications.PubMedCrossRefGoogle Scholar
  128. 128.•
    Pruitt AA. Neurologic complications of infective endocarditis. Curr Treat Options Neurol. 2013;15(4):465–76. A review of diagnosis, treatment, complication and special situations in patients with infective endocarditis.PubMedCrossRefGoogle Scholar
  129. 129.
    Sonneville R, Mirable M, Hajage D, et al. Neurologic complications and outcomes of infective endocarditis in critically ill patients: the ENDOcardite en REAnimation prospective multicenter study. Crit Care Med. 2011;39(6):1474–81.PubMedCrossRefGoogle Scholar
  130. 130.
    Thuny F, Di Salvo G, Belliard O, et al. Risk of embolism and death in infective endocarditis: prognostic value of echocardiography: a prospective multicenter study. Circulation. 2005;112(1):69–75.PubMedCrossRefGoogle Scholar
  131. 131.
    Salgado AV, Furlan AJ, Keys TF, et al. Neurologic complications of endocarditis: a 12-year experience. Neurology. 1989;39(2 Pt 1):173–8.PubMedCrossRefGoogle Scholar
  132. 132.
    Torvik A. The pathogenesis of watershed infarcts in the brain. Stroke. 1984;15(2):221–3.PubMedCrossRefGoogle Scholar
  133. 133.•
    Sorgun MH, Rzayev S, Yilmaz V, Isıkay CT. Etiologic subtypes of watershed infarcts. J Stroke Cerebrovasc Dis. 2015;24(11):2478–83. A retrospective study of stroke patients showing that cardioembolism and large-artery atherosclerosis were the most common causes of cortical and subcortical border-zone infarct respectively.PubMedCrossRefGoogle Scholar
  134. 134.•
    Joinlambert C, Saliou G, Flamand-Roze C, et al. Cortical border-zone infarcts: clinical features, causes and outcome. J Neurol Neurosurg Psychiatry. 2012;83(8):771–5. A prospective cohort study of stroke patients showing clinical presentation and prognosis of border-zone infarct.PubMedCrossRefGoogle Scholar
  135. 135.•
    Windecker S, Stortecky S, Meier B. Paradoxical embolism. J Am Coll Cardiol. 2014;64(4):403–15. A review of clinical features, diagnosis, treatment and prevention of paradoxical embolism.PubMedCrossRefGoogle Scholar
  136. 136.
    Rogers LR. Cerebrovascular complications in cancer patients. Neurol Clin. 2003;21(1):167–92.PubMedCrossRefGoogle Scholar
  137. 137.•
    Artoni A, Bucciarelli P, Martinelli I. Cerebral thrombosis and myeloproliferative neoplasms. Curr Neurol Neurosci Rep. 2014;14(11):496. A detailed review of the pathophysiology, epidemiology, prevention and treatment of arterial and venous cerebral thrombosis due to myeloproliferative neoplasms.PubMedCrossRefGoogle Scholar
  138. 138.
    Blumenthal DT, Glenn MJ. Neurologic manifestations of hematologic disorders. Neurol Clin. 2002;20(1):265–81. viii.PubMedCrossRefGoogle Scholar
  139. 139.
    Meloni G, Proia A, Antonini G, et al. Thrombotic thrombocytopenic purpura: prospective neurologic, neuroimaging and neurophysiologic evaluation. Hemost Thromb. 2001;86(11):1194–9.Google Scholar
  140. 140.
    Boattini M, Procaccianti G. Stroke due to typical thrombotic thrombocytopenic purpura treated successfully with intravenous thrombolysis and therapeutic plasma exchange. BMJ Case Rep. 2013. doi: 10.1136/bcr-2012-008426.Google Scholar
  141. 141.
    Yun YW, Chung S, You SJ, et al. Cerebral infarction as a complication of nephrotic syndrome: a case report with a review of the literature. J Korean Med Sci. 2004;19(2):315–9.PubMedPubMedCentralCrossRefGoogle Scholar
  142. 142.
    Levi M, Opal SM. Coagulation abnormalities in critically ill patients. Crit Care. 2006;10(4):222.PubMedPubMedCentralCrossRefGoogle Scholar
  143. 143.•
    Ramot Y, Nyska A, Spectre G. Drug-induced thrombosis: an update. Drug Saf. 2013;36(8):585–603. A comprehensive review of the different mechanisms of drug induced thrombosis.PubMedCrossRefGoogle Scholar
  144. 144.
    LaMonte MP, Brown PM, Hursting MJ. Stroke in patients with heparin-induced thrombocytopenia and the effect of argatroban therapy. Crit Care Med. 2004;32(4):976–8.PubMedCrossRefGoogle Scholar
  145. 145.
    Bell CM, Brener SS, Gunraj N, et al. Association of ICU or hospital admission with unintentional discontinuation of medications for chronic diseases. JAMA. 2011;306(8):840–7.PubMedCrossRefGoogle Scholar
  146. 146.
    Broderick JP, Bonomo JB, Kissela BM, et al. Withdrawal of antithrombotic agents and its impact on ischemic stroke occurrence. Stroke. 2011;42(4):2509–14.PubMedPubMedCentralCrossRefGoogle Scholar
  147. 147.
    Hart RG, Tonarelli SB, Pearce L. Avoiding central nervous system bleeding during antithrombotic therapy: recent data and ideas. Stroke. 2005;36(7):1588–93.PubMedCrossRefGoogle Scholar
  148. 148.
    Kase CS. Intracerebral hemorrhage : non-hypertensive causes. Stroke. 1986;17(4):590–5.PubMedCrossRefGoogle Scholar
  149. 149.
    Gurwitz JH, Gore JM, Goldber RJ, et al. Risk for intracranial hemorrhage after tissue plasminogen activator treatment for acute myocardial infarction. Ann Intern. 1998;129(8):597–604.CrossRefGoogle Scholar
  150. 150.
    Hacke W, Kaste M, Bluhmki E, et al. Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke. N Engl J Med. 2008;359(13):1317–29.PubMedCrossRefGoogle Scholar
  151. 151.
    Werner N, Zahn R, Zeymer U. Stroke in patients undergoing coronary angiography and percutaneous coronary intervention: incidence, predictors, outcome and therapeutic options. Expert Rev Cardiovasc Ther. 2012;10(10):1297–305.PubMedCrossRefGoogle Scholar
  152. 152.
    Dawson DM, Fischer EG. Neurologic complications of cardiac catheterization. Neurology. 1977;27(5):496–8.PubMedCrossRefGoogle Scholar
  153. 153.•
    Osias J, Manno E. Neuromuscular complications of critical illness. Crit Care Clin. 2012;30(4):785–94. A detailed review of the pathophysiology, diagnosis, treatment and prognosis of critical illness polyneuropathy and myopathy, including thick filament myosin loss, rhabdomyolysis, cachetic myopathy, and acute necrotizing myopathy.CrossRefGoogle Scholar
  154. 154.
    Bolton CF. Neuromuscular complications of sepsis. Intensive Care Med. 1993;19 Suppl 2:S58–63.PubMedCrossRefGoogle Scholar
  155. 155.•
    Apostolakis E, Papakonstantinou NA, Baikoussis NG, Papadopoulos G. Intensive care unit-related generalized neuromuscular weakness due to critical illness polyneuropathy/myopathy in critically ill patients. J Anesth. 2015;29(1):112–21. An updated review of critical illness myopathy and neuropathy focusing on risk factors, prevention and prognosis.PubMedCrossRefGoogle Scholar
  156. 156.•
    Parker AM, Sricharoenchai T, Raparla S, et al. Posttraumatic stress disorder in critical illness survivors : a metaanalysis. Crit Care Med. 2015;43(5):1121–9. A meta-analysis and systematic review of 40 articles of the prevalence, risk factors, prevention and treatment strategies of posttraumatic stress disorder in ICU patients.PubMedCrossRefGoogle Scholar
  157. 157.
    Peris A, Bonizzoli M, Iozzelli D, et al. Early intra-intensive care unit psychological intervention promotes recovery from post traumatic stress disorders, anxiety and depression symptoms in critically ill patients. Crit Care. 2011;15(1):R41.PubMedPubMedCentralCrossRefGoogle Scholar
  158. 158.•
    Jackson JC, Pandharipande PP, Girard TD, et al. Depression, post-traumatic stress disorder, and functional disability in survivors of critical illness in the BRAIN-ICU (Bringing to light the Risk Factors And Incidence of Neuropsychological dysfunction in ICU survivors) study: a longitudinal cohort study. Lancet Respir. 2014;2(5):369–79. A prospective, multisite cohort study showing outcome and functional disability, age effects and risk factors of depression and posttraumatic stress disorder in 821 medical and surgical ICU patients.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.Department of NeurologyLoyola University Chicago-Stritch School of MedicineMaywoodUSA

Personalised recommendations