Latest posts
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🧠 When Raising CPP Won’t Help: The Type 2 Picture on Cerebral Microdialysis
The lactate/pyruvate ratio is climbing, but ICP, CPP and PbtO2 all look fine. If pyruvate is normal, the problem is not delivery — it is…
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🧠 The Sleep Switch: Why a Patient on Dexmedetomidine Wakes When You Call Them
Dexmedetomidine does not blanket the cortex the way propofol does. It flips a switch the brain already owns — the VLPO flip-flop circuit. That single…
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🧠 ATTENTION-LATE: Does Tenecteplase Before Thrombectomy Help in Late Basilar Artery Occlusion?
Should a patient with a basilar artery occlusion who reaches a thrombectomy centre 4.5 to 24 hours after onset get tenecteplase first? The ATTENTION-LATE trial…
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🧠 The Skull Is Not a Sealed Box: How AI Is Learning to Read Brain Pressure Without a Drill
For decades, measuring intracranial pressure (ICP) meant one thing: putting a hole in the skull. A bolt, a catheter, a strain gauge pushed into brain…
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🧠 The Stroke Surgery Trial That’s Forcing Neurosurgeons To Rethink The Rulebook
For decades, surgery for brain hemorrhage carried a quiet stigma. Two landmark trials had already tried to prove it works and came up empty. In…
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Rewriting the Rules for Brain Bleeds: What INTERACT3 Taught Us
Spontaneous intracerebral haemorrhage has long carried an air of clinical resignation, the diagnosis that quietly lowered everyone’s expectations before treatment had even begun. INTERACT3, published…
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Reading the Pupil Anew: Automated Pupillometry in Neurological Monitoring
For over a century, the pupillary examination has rested on a simple ritual: a clinician, a penlight, and a judgement rendered in an instant —…
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How Much Blood Does an Injured Brain Need? What do HEMOTION and TRAIN tell?
The messages For years, ICUs treated anemia in brain-injured patients like anemia in anyone else: transfuse only when hemoglobin falls to about 70 g/L. Two…
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Bedside Weaning Assessment for Myasthenia Gravis
Bedside Test Procedure Normal / Reassuring Value Clinical Significance (Red Flag) Clinical Assessment Observe for signs of respiratory distress and bulbar weakness (speech, swallowing). No…
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Pulsatility Index (PI)
The TCD Pulsatility Index (PI) is a parameter used in Transcranial Doppler (TCD) ultrasonography to evaluate the resistance to blood flow in cerebral vessels. It’s commonly used to assess cerebral hemodynamics, especially…