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Managing ICP in TBI Patients

One of the central things we do for neuro patients in control their ICP. But, does tight control of ICP improve outcomes? Is ICP the best thing for us to be optimizing, especially if brain ischemia is what we’re trying to avoid? What about brain tissue oxygenation? I’ll quickly review the evidence, and you decide.…

OR Attire

What is the evidence behind the things we are forced to wear in the OR? Do they help? Are they voodoo? On this episode, Karl takes us through the evidence behind the different pieces of OR attire. Some things seem to work… some things do nothing… some things might actually be harmful. 🤨 Literature Referenced:…

TIA – Awareness under anesthesia

Our inaugural TIA! (mini-episodes reviewing a specific article) This one is is discussing an article that measured awareness under anesthesia – more common than you might expect… Sanders, R., Gaskell, A., Raz, A., Winders, J., Stevanovic, A., Rossaint, R., Boncyk, C., Defresne, A., Tran, G., Tasbihgou, S., Meier, S., Vlisides, P., Fardous, H., Hess, A., Bauer,…

History of Neurosurgery

This episode we cover a brief overview of the history of neurosurgery, from ancient trephination through the contributions of Harvey Cushing in establishing the modern field. How far back were people doing surgery on the head? What was holding us back from doing real brain surgeries, and why did it not flourish until this century?…

Recovery in Severe TBI

How good are we at predicting outcome in severe TBI? Do all patients do bad, or are there some that recover? On this episode Karl dives into the data to give us an update on what the data supports. Literature Referenced: What early predictions do we make? Barlow, P., Teasdale, G. (1986). Prediction of Outcome…

Ketamine in TBIs

Is ketamine safe to use in TBI patients (or anyone with increased ICP)? The usual answer is “heck no!”, but where does this come from, and is it true? This week, Karl and I talk about the origin of this believe and the evidence behind the safety of ketamine in TBIs (and how it might…

Does dexamethasone worsen mortality in GBM?

Really? Decadron can worsen mortality in GBMs? This week Karl and I go over the evidence showing that steroids might not be the best thing for GBM patients. Specifically, it looks like dexamethasone might interfere with the effectiveness of chemo and radiation, leading to worse outcomes. Literature Referenced: Opinion paper that summarizes the argument against…