Intracranial Pressure Monitoring and Management in Aneurysmal Subarachnoid Hemorrhage.


Journal

Neurocritical care
ISSN: 1556-0961
Titre abrégé: Neurocrit Care
Pays: United States
ID NLM: 101156086

Informations de publication

Date de publication:
08 2023
Historique:
received: 31 05 2022
accepted: 12 05 2023
medline: 14 9 2023
pubmed: 7 6 2023
entrez: 6 6 2023
Statut: ppublish

Résumé

Aneurysmal subarachnoid hemorrhage is a medical condition that can lead to intracranial hypertension, negatively impacting patients' outcomes. This review article explores the underlying pathophysiology that causes increased intracranial pressure (ICP) during hospitalization. Hydrocephalus, brain swelling, and intracranial hematoma could produce an ICP rise. Although cerebrospinal fluid withdrawal via an external ventricular drain is commonly used, ICP monitoring is not always consistently practiced. Indications for ICP monitoring include neurological deterioration, hydrocephalus, brain swelling, intracranial masses, and the need for cerebrospinal fluid drainage. This review emphasizes the importance of ICP monitoring and presents findings from the Synapse-ICU study, which supports a correlation between ICP monitoring and treatment with better patient outcomes. The review also discusses various therapeutic strategies for managing increased ICP and identifies potential areas for future research.

Identifiants

pubmed: 37280411
doi: 10.1007/s12028-023-01752-y
pii: 10.1007/s12028-023-01752-y
pmc: PMC10499755
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

59-69

Informations de copyright

© 2023. The Author(s).

Références

Chou SH-Y. Subarachnoid Hemorrhage. Contin Lifelong Learn Neurol. 2021;27:1201–45.
doi: 10.1212/CON.0000000000001052
Claassen J, Park S. Spontaneous subarachnoid hemorrhage. Lancet. 2022;400(10355):846–62.
pubmed: 35985353 pmcid: 9987649 doi: 10.1016/S0140-6736(22)00938-2
Macdonald RL, Diringer MN, Citerio G. Understanding the disease: aneurysmal subarachnoid hemorrhage. Intensive Care Med. 2014;40:1940–3.
pubmed: 25223854 doi: 10.1007/s00134-014-3483-5
Cossu G, Messerer M, Stocchetti N, Levivier M, Daniel RT, Oddo M. Intracranial pressure and outcome in critically ill patients with aneurysmal subarachnoid hemorrhage: a systematic review. Minerva Anestesiol. 2016;82:684–96.
pubmed: 27045637
Connolly ES, Rabinstein AA, Carhuapoma JR, Derdeyn CP, Dion J, Higashida RT, et al. Guidelines for the management of aneurysmal subarachnoid hemorrhage. Stroke. 2012;43:1711–37.
pubmed: 22556195 doi: 10.1161/STR.0b013e3182587839
Picetti E, Berardino M, Bertuccio A, Bertuetti R, Boccardi EP, Caricato A, et al. Early management of patients with aneurysmal subarachnoid hemorrhage in a hospital without neurosurgical/neuroendovascular facilities: a consensus and clinical recommendations of the Italian Society of Anesthesia and Intensive Care (SIAARTI). J Anesth Analg Crit Care. 2021;1:10.
pubmed: 37386668 pmcid: 10245649 doi: 10.1186/s44158-021-00012-9
Alotaibi NM, Wang JZ, Pasarikovski CR, Guha D, Al-Mufti F, Mamdani M, et al. Management of raised intracranial pressure in aneurysmal subarachnoid hemorrhage: Time for a consensus? Neurosurg Focus. 2017;43:E13.
pubmed: 29088956 doi: 10.3171/2017.7.FOCUS17426
Treggiari MM, Rabinstein AA, Busl KM, et al. Guidelines for the neurocritical care management of aneurysmal subarachnoid hemorrhage. Neurocrit Care. 2023. https://doi.org/10.1007/s12028-023-01713-5 .
doi: 10.1007/s12028-023-01713-5 pubmed: 37535174
Claassen J, Carhuapoma JR, Kreiter KT, Du EY, Connolly ES, Mayer SA. Global cerebral edema after subarachnoid hemorrhage: frequency, predictors, and impact on outcome. Stroke. 2002;33:1225–32.
pubmed: 11988595 doi: 10.1161/01.STR.0000015624.29071.1F
Helbok R, Ko SB, Schmidt JM, Kurtz P, Fernandez L, Choi HA, et al. Global cerebral edema and brain metabolism after subarachnoid hemorrhage. Stroke. 2011;42(6):1534–9.
pubmed: 21493918 doi: 10.1161/STROKEAHA.110.604488
Voldby B, Enevoldsen EM. Intracranial pressure changes following aneurysm rupture. Part 3: recurrent hemorrhage. J Neurosurg. 1982;56:784–9.
pubmed: 7077377 doi: 10.3171/jns.1982.56.6.0784
Lauzier DC, Jayaraman K, Yuan JY, Diwan D, Vellimana AK, Osbun JW, et al. Early brain injury after subarachnoid hemorrhage: incidence and mechanisms. Stroke. 2023;54(5):1426–40.
pubmed: 36866673 doi: 10.1161/STROKEAHA.122.040072
Fang Y, Huang L, Wang X, Si X, Lenahan C, Shi H, et al. A new perspective on cerebrospinal fluid dynamics after subarachnoid hemorrhage: From normal physiology to pathophysiological changes. J Cereb Blood Flow Metab. 2021;42:543–58.
pubmed: 34806932 pmcid: 9051143 doi: 10.1177/0271678X211045748
Lv Y, Wang D, Lei J, Tan G. Clinical observation of the time course of raised intracranial pressure after subarachnoid hemorrhage. Neurol Sci. 2015;36(7):1203–10.
pubmed: 25604576 doi: 10.1007/s10072-015-2073-9
Zoerle T, Lombardo A, Colombo A, Longhi L, Zanier ER, Rampini P, et al. Intracranial pressure after subarachnoid hemorrhage. Crit Care Med. 2015;43:168–76.
pubmed: 25318385 doi: 10.1097/CCM.0000000000000670
Hayman EG, Wessell A, Gerzanich V, Sheth KN, Simard JM. Mechanisms of global cerebral edema formation in aneurysmal subarachnoid hemorrhage. Neurocrit Care. 2017;26:301–10.
pubmed: 27995510 pmcid: 5336395 doi: 10.1007/s12028-016-0354-7
Macdonald RL, Schweizer TA. Spontaneous subarachnoid haemorrhage. Lancet. 2017;389:655–66.
pubmed: 27637674 doi: 10.1016/S0140-6736(16)30668-7
Lidington D, Wan H, Bolz S-S. Cerebral autoregulation in subarachnoid hemorrhage. Front Neurol. 2021;12: 688362.
pubmed: 34367053 pmcid: 8342764 doi: 10.3389/fneur.2021.688362
Kuo LT, Huang APH. The pathogenesis of hydrocephalus following aneurysmal subarachnoid hemorrhage. Int J Mol Sci. 2021;22:5050.
pubmed: 34068783 pmcid: 8126203 doi: 10.3390/ijms22095050
Russo PD, Carlo DTD, Lutenberg A, Morganti R, Evins AI, Perrini P. Shunt-dependent hydrocephalus after aneurysmal subarachnoid hemorrhage. J Neurosurg Sci. 2019;64:181–9.
pubmed: 30942051
Roux PL, Menon DK, Citerio G, Vespa P, Bader MK, Brophy GM, et al. Consensus summary statement of the international multidisciplinary consensus conference on multimodality monitoring in neurocritical care. Intens Care Med. 2014;40:1189–209.
Monitoring TP in the IMCC on M, Helbok R, Olson DM, Roux PDL, Vespa P. Intracranial pressure and cerebral perfusion pressure monitoring in non-TBI patients: special considerations. Neurocrit Care. 2014;21:85–94.
doi: 10.1007/s12028-014-0040-6
Picetti E, Barbanera A, Bernucci C, Bertuccio A, Bilotta F, Boccardi EP, et al. Early management of patients with aneurysmal subarachnoid hemorrhage in a hospital with neurosurgical/neuroendovascular facilities: a consensus and clinical recommendations of the Italian Society of Anesthesia and Intensive Care (SIAARTI)–Part 1. J Anesth Analg Crit Care. 2022;2:13.
pubmed: 37386557 pmcid: 10245531 doi: 10.1186/s44158-022-00042-x
Hawryluk GWJ, Citerio G, Hutchinson P, Kolias A, Meyfroidt G, Robba C, et al. Intracranial pressure: current perspectives on physiology and monitoring. Intensive Care Med. 2022;48:1471–81.
pubmed: 35816237 doi: 10.1007/s00134-022-06786-y
Liu X, Griffith M, Jang HJ, Ko N, Pelter MM, Abba J, et al. Intracranial pressure monitoring via external ventricular drain: Are we waiting long enough before recording the real value? J Neurosci Nurs. 2020;52:37–42.
pubmed: 31899715 pmcid: 7029488 doi: 10.1097/JNN.0000000000000487
Coppadoro A, Citerio G. Subarachnoid hemorrhage: an update for the intensivist. Minerva Anestesiol. 2011;77:74–84.
pubmed: 21273968
Gigante P, Hwang BY, Appelboom G, Kellner CP, Kellner MA, Connolly ES. External ventricular drainage following aneurysmal subarachnoid haemorrhage. Br J Neurosurg. 2010;24:625–32.
pubmed: 20854058 doi: 10.3109/02688697.2010.505989
Robba C, Graziano F, Rebora P, Elli F, Giussani C, Oddo M, et al. Intracranial pressure monitoring in patients with acute brain injury in the intensive care unit (SYNAPSE-ICU): an international, prospective observational cohort study. Lancet Neurol. 2021;20:548–58.
pubmed: 34146513 doi: 10.1016/S1474-4422(21)00138-1
Baggiani M, Graziano F, Rebora P, Robba C, Guglielmi A, Galimberti S, et al. Intracranial pressure monitoring practice, treatment, and effect on outcome in aneurysmal subarachnoid hemorrhage. Neurocrit Care. 2022. https://doi.org/10.1007/s12028-022-01651-8 .
doi: 10.1007/s12028-022-01651-8 pubmed: 36471182
Hellingman CA, van den Bergh WM, Beijer IS, van Dijk GW, Algra A, van Gijn J, et al. Risk of rebleeding after treatment of acute hydrocephalus in patients with aneurysmal subarachnoid hemorrhage. Stroke. 2007;38:96–9.
pubmed: 17122426 doi: 10.1161/01.STR.0000251841.51332.1d
Heuer GG, Smith MJ, Elliott JP, Winn HR, Leroux PD. Relationship between intracranial pressure and other clinical variables in patients with aneurysmal subarachnoid hemorrhage. J Neurosurg. 2004;101:408–16.
pubmed: 15352597 doi: 10.3171/jns.2004.101.3.0408
McIver JI, Friedman JA, Wijdicks EFM, Piepgras DG, Pichelmann MA, Toussaint LG, et al. Preoperative ventriculostomy and rebleeding after aneurysmal subarachnoid hemorrhage. J Neurosurg. 2002;97:1042–4.
pubmed: 12452133 doi: 10.3171/jns.2002.97.5.1042
Hanley DF, Lane K, McBee N, Ziai W, Tuhrim S, Lees KR, et al. Thrombolytic removal of intraventricular haemorrhage in treatment of severe stroke: results of the randomised, multicentre, multiregion, placebo-controlled CLEAR III trial. Lancet. 2017;389:603–11.
pubmed: 28081952 pmcid: 6108339 doi: 10.1016/S0140-6736(16)32410-2
Robba C, Santori G, Czosnyka M, Corradi F, Bragazzi N, Padayachy L, et al. Optic nerve sheath diameter measured sonographically as noninvasive estimator of intracranial pressure: a systematic review and meta-analysis. Intensive Care Med. 2018;44:1284–94.
pubmed: 30019201 doi: 10.1007/s00134-018-5305-7
Zoerle T, Caccioppola A, D’Angelo E, Carbonara M, Conte G, Avignone S, et al. Optic nerve sheath diameter is not related to intracranial pressure in subarachnoid hemorrhage patients. Neurocrit Care. 2020;33:491–8.
pubmed: 32314244 doi: 10.1007/s12028-020-00970-y
Cardim D, Robba C, Czosnyka M, Savo D, Mazeraud A, Iaquaniello C, et al. Noninvasive intracranial pressure estimation with transcranial doppler: a prospective observational study. J Neurosurg Anesth. 2020;32:349–53.
doi: 10.1097/ANA.0000000000000622
Cagnazzo F, Chalard K, Lefevre P-H, Garnier O, Derraz I, Dargazanli C, et al. Optimal intracranial pressure in patients with aneurysmal subarachnoid hemorrhage treated with coiling and requiring external ventricular drainage. Neurosurg Rev. 2021;44:1191–204.
pubmed: 32458277 doi: 10.1007/s10143-020-01322-2
Fugate JE, Rabinstein AA, Wijdicks EFM, Lanzino G. Aggressive CSF diversion reverses delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage: a case report. Neurocrit Care. 2012;17:112–6.
pubmed: 22644888 doi: 10.1007/s12028-012-9723-z
Samuelsson C, Hillered L, Enblad P, Ronne-Engström E. Microdialysis patterns in subarachnoid hemorrhage patients with focus on ischemic events and brain interstitial glutamine levels. Acta Neurochir (Wien). 2009;151:437–46 (discussion 446).
pubmed: 19296052 doi: 10.1007/s00701-009-0265-x
Samuelsson C, Howells T, Kumlien E, Enblad P, Hillered L, Ronne-Engström E. Relationship between intracranial hemodynamics and microdialysis markers of energy metabolism and glutamate-glutamine turnover in patients with subarachnoid hemorrhage. J Neurosurg. 2009;111:910–5.
pubmed: 19425889 doi: 10.3171/2008.8.JNS0889
Vik A, Nag T, Fredriksli OA, Skandsen T, Moen KG, Schirmer-Mikalsen K, et al. Relationship of “dose” of intracranial hypertension to outcome in severe traumatic brain injury. J Neurosurg. 2008;109:678–84.
pubmed: 18826355 doi: 10.3171/JNS/2008/109/10/0678
Citerio G, Gaini SM, Tomei G, Stocchetti N. Management of 350 aneurysmal subarachnoid hemorrhages in 22 Italian neurosurgical centers. Intensive Care Med. 2007;33:1580–6.
pubmed: 17541545 doi: 10.1007/s00134-007-0700-5
Magni F, Pozzi M, Rota M, Vargiolu A, Citerio G. High-resolution intracranial pressure burden and outcome in subarachnoid hemorrhage. Stroke. 2015;46:2464–9.
pubmed: 26243224 doi: 10.1161/STROKEAHA.115.010219
Carra G, Elli F, Ianosi B, Flechet M, Huber L, Rass V, et al. Association of dose of intracranial hypertension with outcome in subarachnoid hemorrhage. Neurocrit Care. 2021;34:722–30.
pubmed: 33846900 doi: 10.1007/s12028-021-01221-4
Ryttlefors M, Howells T, Nilsson P, Ronne-Engström E, Enblad P. Secondary insults in subarachnoid hemorrhage: occurrence and impact on outcome and clinical deterioration. Neurosurgery. 2007;61:704–14 (discussion 714-5).
pubmed: 17986931 doi: 10.1227/01.NEU.0000298898.38979.E3
Carney N, Totten AM, O’Reilly C, Ullman JS, Hawryluk GWJ, Bell MJ, et al. Guidelines for the management of severe traumatic brain injury. Neurosurgery. 2017;80:6–15.
pubmed: 27654000 doi: 10.1227/NEU.0000000000001432
Ravishankar N, Nuoman R, Amuluru K, El-Ghanem M, Thulasi V, Dangayach NS, et al. Management strategies for intracranial pressure crises in subarachnoid hemorrhage. J Intensive Care Med. 2018;35:211–8.
pubmed: 30514150 doi: 10.1177/0885066618813073
Kim GS, Amato A, James ML, Britz GW, Zomorodi A, Graffagnino C, et al. Continuous and intermittent CSF diversion after subarachnoid hemorrhage: a pilot study. Neurocrit Care. 2011;14:68–72.
pubmed: 20596794 doi: 10.1007/s12028-010-9401-y
Olson DM, Zomorodi M, Britz GW, Zomorodi AR, Amato A, Graffagnino C. Continuous cerebral spinal fluid drainage associated with complications in patients admitted with subarachnoid hemorrhage. J Neurosurg. 2013;119:974–80.
pubmed: 23957382 doi: 10.3171/2013.6.JNS122403
Palasz J, D’Antona L, Farrell S, Elborady MA, Watkins LD, Toma AK. External ventricular drain management in subarachnoid haemorrhage: a systematic review and meta-analysis. Neurosurg Rev. 2022;45:365–73.
pubmed: 34448080 doi: 10.1007/s10143-021-01627-w
Fried HI, Nathan BR, Rowe AS, Zabramski JM, Andaluz N, Bhimraj A, et al. The insertion and management of external ventricular drains: an evidence-based consensus statement: a statement for healthcare professionals from the Neurocritical Care Society. Neurocrit Care. 2016;24:61–81.
pubmed: 26738503 doi: 10.1007/s12028-015-0224-8
Chung DY, Leslie-Mazwi TM, Patel AB, Rordorf GA. Management of external ventricular drains after subarachnoid hemorrhage: a multi-institutional survey. Neurocrit Care. 2017;26(3):356–61.
pubmed: 28000129 pmcid: 5444979 doi: 10.1007/s12028-016-0352-9
Capion T, Lilja-Cyron A, Bartek J, Forsse A, Logallo N, Juhler M, et al. Discontinuation of external ventricular drainage in patients with hydrocephalus following aneurysmal subarachnoid hemorrhage—a scandinavian multi-institutional survey. Acta Neurochir (Wien). 2020;162:1363–70.
pubmed: 32322997 doi: 10.1007/s00701-020-04317-6
Staykov D, Schwab S. Clearing bloody cerebrospinal fluid: clot lysis, neuroendoscopy and lumbar drainage. Curr Opin Crit Care. 2013;19:92–100.
pubmed: 23337912 doi: 10.1097/MCC.0b013e32835cae5e
Wolf S. Rationale for lumbar drains in aneurysmal subarachnoid hemorrhage. Curr Opin Crit Care. 2015;21:120–6.
pubmed: 25692806 doi: 10.1097/MCC.0000000000000183
Al-Tamimi YZ, Bhargava D, Feltbower RG, Hall G, Goddard AJP, Quinn AC, et al. Lumbar drainage of cerebrospinal fluid after aneurysmal subarachnoid hemorrhage: a prospective, randomized, controlled trial (LUMAS). Stroke. 2012;43:677–82.
pubmed: 22282887 doi: 10.1161/STROKEAHA.111.625731
Hawryluk GWJ, Aguilera S, Buki A, Bulger E, Citerio G, Cooper DJ, et al. A management algorithm for patients with intracranial pressure monitoring: the Seattle International Severe Traumatic Brain Injury Consensus Conference (SIBICC). Intensive Care Med. 2019;45:1783–94.
pubmed: 31659383 pmcid: 6863785 doi: 10.1007/s00134-019-05805-9
Brian JE. Carbon dioxide and the cerebral circulation. Anesthesiology. 1998;88:1365–86.
pubmed: 9605698 doi: 10.1097/00000542-199805000-00029
Meng L, Gelb AW. Regulation of cerebral autoregulation by carbon dioxide. Anesthesiology. 2015;122:196–205.
pubmed: 25401418 doi: 10.1097/ALN.0000000000000506
Hoiland RL, Fisher JA, Ainslie PN. Regulation of the cerebral circulation by arterial carbon dioxide. Compr Physiol. 2019;9:1101–54.
pubmed: 31187899 doi: 10.1002/cphy.c180021
Diringer MN, Zazulia AR. Osmotic therapy: fact and fiction. Neurocrit Care. 2004;1:219–33.
pubmed: 16174920 doi: 10.1385/NCC:1:2:219
Oddo M, Poole D, Helbok R, Meyfroidt G, Stocchetti N, Bouzat P, et al. Fluid therapy in neurointensive care patients: ESICM consensus and clinical practice recommendations. Intensive Care Med. 2018;44(4):449–63.
pubmed: 29500701 doi: 10.1007/s00134-018-5086-z
Poole D, Citerio G, Helbok R, Ichai C, Meyfroidt G, Oddo M, et al. Evidence for mannitol as an effective agent against intracranial hypertension: an individual patient data meta-analysis. Neurocrit Care. 2019;312:71.
Koenig MA, Bryan M, Lewin JL, Mirski MA, Geocadin RG, Stevens RD. Reversal of transtentorial herniation with hypertonic saline. Neurology. 2008;70:1023–9.
pubmed: 18272864 doi: 10.1212/01.wnl.0000304042.05557.60
Pasarikovski CR, Alotaibi NM, Al-Mufti F, Macdonald RL. Hypertonic saline for increased intracranial pressure after aneurysmal subarachnoid hemorrhage: a systematic review. World Neurosurg. 2017;105:1–6.
pubmed: 28549643 doi: 10.1016/j.wneu.2017.05.085
Bentsen G, Stubhaug A, Eide PK. Differential effects of osmotherapy on static and pulsatile intracranial pressure. Crit Care Med. 2008;36:2414–9.
pubmed: 18596629 doi: 10.1097/CCM.0b013e318180fe04
Todd MM, Hindman BJ, Clarke WR, Torner JC, Investigators IH for ASTI. Mild intraoperative hypothermia during surgery for intracranial aneurysm. N Engl J Med. 2005;352:135–45.
pubmed: 15647576 doi: 10.1056/NEJMoa040975
Naidech AM, Bendok BR, Bernstein RA, Alberts MJ, Batjer HH, Watts CM, et al. Fever burden and functional recovery after subarachnoid hemorrhage. Neurosurgery. 2008;63:212–7 (discussion 217-8).
pubmed: 18797350 doi: 10.1227/01.NEU.0000320453.61270.0F
Fernandez A, Schmidt JM, Claassen J, Pavlicova M, Huddleston D, Kreiter KT, et al. Fever after subarachnoid hemorrhage: risk factors and impact on outcome. Neurology. 2007;68:1013–9.
pubmed: 17314332 doi: 10.1212/01.wnl.0000258543.45879.f5
Oliveira-Filho J, Ezzeddine MA, Segal AZ, Buonanno FS, Chang Y, Ogilvy CS, et al. Fever in subarachnoid hemorrhage: relationship to vasospasm and outcome. Neurology. 2001;56:1299–304.
pubmed: 11376177 doi: 10.1212/WNL.56.10.1299
Scaravilli V, Tinchero G, Citerio G. Hemorrhage P in the IM-DCC on the CCM of S. Fever Manag SAH Neurocrit Care. 2011;15:287–94.
doi: 10.1007/s12028-011-9588-6
Oddo M, Frangos S, Milby A, Chen I, Maloney-Wilensky E, Murtrie EM, et al. Induced normothermia attenuates cerebral metabolic distress in patients with aneurysmal subarachnoid hemorrhage and refractory Fever. Stroke. 2009;40:1913–6.
pubmed: 19246699 doi: 10.1161/STROKEAHA.108.534115
Kolias AG, Kirkpatrick PJ, Hutchinson PJ. Decompressive craniectomy: past, present and future. Nat Rev Neurol. 2013;9:405–15.
pubmed: 23752906 doi: 10.1038/nrneurol.2013.106
Quig N, Shastri D, Zeitouni D, Yap E, Sasaki-Adams D. Bilateral decompressive hemicraniectomy for diffuse cerebral edema and medically refractory elevated intracranial pressure in aneurysmal subarachnoid hemorrhage: a case series. Cureus. 2021;13: e18057.
pubmed: 34671533 pmcid: 8520698
Robba C, Graziano F, Guglielmi A, Rebora P, Galimberti S, Taccone FS, et al. Treatments for intracranial hypertension in acute brain-injured patients: grading, timing, and association with outcome. Data from the SYNAPSE-ICU study. Intensive Care Med. 2023;49:50–61.
pubmed: 36622462 pmcid: 9852114 doi: 10.1007/s00134-022-06937-1
Zeineddine HA, Divito A, McBride DW, Pandit P, Capone S, Dawes BH, et al. Subarachnoid blood clearance and aneurysmal subarachnoid hemorrhage outcomes: a retrospective review. Neurocrit Care. 2023;1–8.
Chesnut R, Aguilera S, Buki A, Bulger E, Citerio G, Cooper DJ, et al. A management algorithm for adult patients with both brain oxygen and intracranial pressure monitoring: the Seattle International Severe Traumatic Brain Injury Consensus Conference (SIBICC). Intensive Care Med. 2020;46:919–29.
pubmed: 31965267 pmcid: 7210240 doi: 10.1007/s00134-019-05900-x

Auteurs

Alberto Addis (A)

School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
Neurological Intensive Care Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico San Gerardo dei Tintori, Monza, Italy.

Marta Baggiani (M)

University Eastern Piedmont, Novara, Italy.

Giuseppe Citerio (G)

School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy. giuseppe.citerio@unimib.it.
Neurological Intensive Care Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico San Gerardo dei Tintori, Monza, Italy. giuseppe.citerio@unimib.it.

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