Neurologic Complications in Non-Neurological Intensive Care Units

Abstract

In this review, we explore a practical systematic approach to patients with decreased level of consciousness. The most common causes of impaired alertness in different non-neurologic critical care units and commonly used prognostication tools are presented. Finally a brief introduction of hypothermia, a novel therapeutic approach is also discussed.

Severe neurological complications in critically ill COVID-19 patients

“…Despite a relatively high incidence of events compared to other ICU patients [13], our observations so far do not pinpoint towards COVID-19-specific neurological complications. This study highlights the importance of a careful use of full intense anticoagulation.…”

Neurological Sequels and Their Causes in Patients Hospitalized in the Toxicology Intensive Care Unit of Bahraloo Hospital, Tehran, Iran

“…The frequency of neurological sequels in internal ICU was increased in previous reports, compared to our findings. Considering the wide range of internal diseases and their neurological complications, this difference is justifiable (1,2).…”

“…Mortality in the presence of neurological sequel, in patients hospitalized in ICU is estimated at about 55% (compared with 29% mortality, in the absence of neurological sequel). The incidence of neurological sequel leads to a two-fold increase in the duration of hospitalization in ICU, disability and the need for ventilator and the duration of the device attachment (1). The 3 -12% overall incidence of neurological complications in a medical ICU has been reported, which include metabolic encephalopathy, seizures, hypoxic-ischemic encephalopathy, stroke, etc.…”

“…Embolism and bleeding into the brain parenchyma occur as medical or iatrogenic complications in the medical ICU (5,6). Myoclonic jerks are common with metabolic disorders, drug consumption and hypoxia cases (1). Encephalopathy is one of the major neurological complications common in the medical ICU.…”

“…Toxicology ICUs are not excluded, as a part of the medical ICU. Besides, the effects of poisoning with drugs on the central nervous system (1) and the association of neurological complications in poisoning with several drugs and toxins must be considered in the toxicology ICU (8)(9)(10)(11). Presently, the ICU of Baharloo Hospital, Tehran, Iran, annually holds a number of cases of poisoning, as one of the active centers in Tehran, in which the evaluation of sequels and neurologic complications, in addition to defining the common cases in the sequels, can be helpful to design preventive or further diagnostic measures to examine the patients hospitalized in this section, to prevent the neurologic sequel, and also, contribute to the evaluation of neurologic sequels, with the most common poisoning cases in this section.…”