2022
Electroencephalogram in the intensive care unit: a focused look at acute brain injury
Alkhachroum A, Appavu B, Egawa S, Foreman B, Gaspard N, Gilmore EJ, Hirsch LJ, Kurtz P, Lambrecq V, Kromm J, Vespa P, Zafar SF, Rohaut B, Claassen J. Electroencephalogram in the intensive care unit: a focused look at acute brain injury. Intensive Care Medicine 2022, 48: 1443-1462. PMID: 35997792, PMCID: PMC10008537, DOI: 10.1007/s00134-022-06854-3.Peer-Reviewed Original ResearchMeSH KeywordsBrain InjuriesElectroencephalographyHumansIntensive Care UnitsSeizuresStatus EpilepticusConceptsAcute brain injuryNonconvulsive status epilepticusBrain injuryStatus epilepticusEEG monitoringIntensive care unit settingRefractory status epilepticusSecondary brain injuryIntensive care unitPossible clinical relevanceAssessment of consciousnessResource-limited settingsICU EEG monitoringFrequent seizuresAcute illnessCommon indicationCare unitWorse outcomesUnit settingClinical relevancePathophysiological eventsSeizure criteriaIschemia monitoringInjuryApplication of electroencephalography
2020
Detecting Seizures and Epileptiform Abnormalities in Acute Brain Injury
Singla S, Garcia GE, Rovenolt GE, Soto AL, Gilmore EJ, Hirsch LJ, Blumenfeld H, Sheth KN, Omay SB, Struck AF, Westover MB, Kim JA. Detecting Seizures and Epileptiform Abnormalities in Acute Brain Injury. Current Neurology And Neuroscience Reports 2020, 20: 42. PMID: 32715371, PMCID: PMC9353690, DOI: 10.1007/s11910-020-01060-4.Peer-Reviewed Original ResearchConceptsIctal-interictal continuumBrain injuryAcute brain injuryBetter clinical outcomesTraumatic brain injuryRecent FindingsCurrent literatureIncreased morbidityClinical outcomesEpileptiform abnormalitiesEEG findingsMortality riskEEG monitoringEpileptiform patternsPrognostic modelSeizuresClinical settingInjuryLogistical barriersElectroencephalogram studyUse of EEGABIPractical barriersEEG analysisEEGMorbidityValidation of an algorithm of time-dependent electro-clinical risk stratification for electrographic seizures (TERSE) in critically ill patients
Cissé FA, Osman GM, Legros B, Depondt C, Hirsch LJ, Struck AF, Gaspard N. Validation of an algorithm of time-dependent electro-clinical risk stratification for electrographic seizures (TERSE) in critically ill patients. Clinical Neurophysiology 2020, 131: 1956-1961. PMID: 32622337, DOI: 10.1016/j.clinph.2020.05.031.Peer-Reviewed Original ResearchConceptsElectrographic seizuresRisk stratificationIll patientsAcute brain injuryContinuous electroencephalography monitoringElectrographic status epilepticusSubgroup of patientsDuration of EEGClinical seizuresConsecutive patientsStatus epilepticusElectroencephalography monitoringBrain injuryMedical recordsSubstantial burdenPatientsClinical practiceCEEGClinical neurophysiologistsSeizuresClinical implementationEEG recordingsTwo-thirdsFuture studiesEEG timeValidation of the 2HELPS2B Seizure Risk Score in Acute Brain Injury Patients
Moffet EW, Subramaniam T, Hirsch LJ, Gilmore EJ, Lee JW, Rodriguez-Ruiz AA, Haider HA, Dhakar MB, Jadeja N, Osman G, Gaspard N, Struck AF. Validation of the 2HELPS2B Seizure Risk Score in Acute Brain Injury Patients. Neurocritical Care 2020, 33: 701-707. PMID: 32107733, DOI: 10.1007/s12028-020-00939-x.Peer-Reviewed Original ResearchConceptsAcute brain injuryClinical factorsContinuous EEG monitoringTraumatic brain injurySeizure incidenceEEG findingsClinical seizuresPrimary outcomeSubdural hematomaBrain injuryEEG monitoringAcute brain injury patientsRisk of seizuresBrain injury patientsReceiver operator characteristic curveOperator characteristic curveABI patientsPatient ageHospitalized patientsElectrographic seizuresInjury patientsIntraparenchymal hemorrhageClinical findingsSubarachnoid hemorrhageResultsA total
2017
Commonalities in epileptogenic processes from different acute brain insults: Do they translate?
Klein P, Dingledine R, Aronica E, Bernard C, Blümcke I, Boison D, Brodie MJ, Brooks‐Kayal A, Engel J, Forcelli PA, Hirsch LJ, Kaminski RM, Klitgaard H, Kobow K, Lowenstein DH, Pearl PL, Pitkänen A, Puhakka N, Rogawski MA, Schmidt D, Sillanpää M, Sloviter RS, Steinhäuser C, Vezzani A, Walker MC, Löscher W. Commonalities in epileptogenic processes from different acute brain insults: Do they translate? Epilepsia 2017, 59: 37-66. PMID: 29247482, PMCID: PMC5993212, DOI: 10.1111/epi.13965.Peer-Reviewed Original ResearchMeSH KeywordsAnimalsBrain InjuriesDisease Models, AnimalEpilepsyHumansTranslational Research, BiomedicalConceptsAcute brain insultsAnimal modelsPrevention therapyBrain insultsBrain injuryInjury etiologyHuman epilepsyClinical testingCentral nervous system infectionFluid percussion injury modelTemporal lobe epilepsy patientsPost-status epilepticus modelDisease modification strategiesNervous system infectionMolecular targetsBetter patient selectionInflammatory cellular infiltrateLoss of neuronsWeeks of injuryBlood-brain barrierTraumatic brain injuryPreclinical animal modelsGap junction couplingCommon histopathologicEpilepsy preventionCyclic seizures in critically ill patients: Clinical correlates, DC recordings and outcomes
Pinto LF, Gilmore EJ, Petroff OA, Sivaraju A, Rampal N, Hirsch LJ, Gaspard N. Cyclic seizures in critically ill patients: Clinical correlates, DC recordings and outcomes. Clinical Neurophysiology 2017, 128: 1083-1090. PMID: 28214108, DOI: 10.1016/j.clinph.2017.01.015.Peer-Reviewed Original ResearchConceptsCyclic seizuresProgressive brain injuryStatus epilepticusIll patientsClinical correlatesBrain injuryDC recordingsNon-convulsive status epilepticusEEG baselineNonconvulsive status epilepticusOlder patientsElectrographic seizuresWorse prognosisFocal onsetPoor outcomePrognostic significanceSeizure initiationPatientsInfraslow activitySeizuresCommon formEpilepticusFurther studiesPosterior regionInjury
2015
Clinical Correlates and Prognostic Significance of Lateralized Periodic Discharges in Patients Without Acute or Progressive Brain Injury
Sainju RK, Manganas LN, Gilmore EJ, Petroff OA, Rampal N, Hirsch LJ, Gaspard N. Clinical Correlates and Prognostic Significance of Lateralized Periodic Discharges in Patients Without Acute or Progressive Brain Injury. Journal Of Clinical Neurophysiology 2015, 32: 495-500. PMID: 26200591, DOI: 10.1097/wnp.0000000000000206.Peer-Reviewed Original ResearchConceptsProgressive brain injuryAcute brain injuryBrain injuryAbnormal consciousnessPeriodic dischargesClinical correlatesFunctional declineLateralized periodic dischargesRemote brain injuryOutcomes of patientsCase-control studyContinuous EEG monitoringHistory of epilepsyRadiologic evidenceHospital dischargeStatus epilepticusWorse prognosisAcute injuryPrognostic significanceWorse outcomesEEG monitoringMultivariate analysisInjuryPatientsLower likelihoodThe enigma of the latent period in the development of symptomatic acquired epilepsy — Traditional view versus new concepts
Löscher W, Hirsch LJ, Schmidt D. The enigma of the latent period in the development of symptomatic acquired epilepsy — Traditional view versus new concepts. Epilepsy & Behavior 2015, 52: 78-92. PMID: 26409135, DOI: 10.1016/j.yebeh.2015.08.037.Peer-Reviewed Original ResearchConceptsBrain injuryLatent periodBrain insultsAnimal modelsMajor unmet clinical needPre-epileptic stateProcess of epileptogenesisUnderstanding of epileptogenesisTraumatic brain injuryUnmet clinical needAntiepileptogenic agentsAntiepileptogenic treatmentsSymptomatic epilepsyHuman epilepsyTrial designFunctional alterationsEpileptogenesisEpilepsySubclinical epilepsyClinical needInjuryPatientsRecent dataInsultPeriod
2010
Intracranial Multimodal Monitoring for Acute Brain Injury: A Single Institution Review of Current Practices
Stuart RM, Schmidt M, Kurtz P, Waziri A, Helbok R, Mayer SA, Lee K, Badjatia N, Hirsch LJ, Connolly ES, Claassen J. Intracranial Multimodal Monitoring for Acute Brain Injury: A Single Institution Review of Current Practices. Neurocritical Care 2010, 12: 188-198. PMID: 20107926, DOI: 10.1007/s12028-010-9330-9.Peer-Reviewed Original ResearchConceptsAcute brain injuryBrain injurySevere acute brain injuryNeurological intensive care unitInsertion techniqueSecondary brain injuryDay of admissionMethodsSixty-one patientsRate of hematomaSingle-institution reviewIntensive care unitBrain tissue oxygenCerebral blood flowFocal brain injuryMultimodality brain monitoringPatient-specific selectionInvasive monitoring devicesHospital lengthFrequent complicationNICU lengthPatient demographicsCare unitMultimodality monitoringConsecutive seriesInstitution review
2009
Intracortical electroencephalography in acute brain injury
Waziri A, Claassen J, Stuart RM, Arif H, Schmidt JM, Mayer SA, Badjatia N, Kull LL, Connolly ES, Emerson RG, Hirsch LJ. Intracortical electroencephalography in acute brain injury. Annals Of Neurology 2009, 66: 366-377. PMID: 19798724, DOI: 10.1002/ana.21721.Peer-Reviewed Original ResearchConceptsSecondary neurological complicationsElectrographic seizuresIctal activityNeurological complicationsScalp electroencephalographyNeurological injuryBrain injuryIntracortical EEGIntensive care unit settingSecondary neurological injurySecondary neuronal injuryAcute brain injuryIll neurological patientsIntracortical electroencephalographyClinical deteriorationNeuronal injuryInvasive neuromonitoringUnderwent implantationNeuromonitoring modalitiesBedside placementIctal dischargesRhythmic deltaUnit settingAcute changesContinuous electroencephalography
2007
Generalized convulsive status epilepticus after nontraumatic subarachnoid hemorrhage: the nationwide inpatient sample.
Claassen J, Bateman BT, Willey JZ, Inati S, Hirsch LJ, Mayer SA, Sacco RL, Schumacher HC. Generalized convulsive status epilepticus after nontraumatic subarachnoid hemorrhage: the nationwide inpatient sample. Neurosurgery 2007, 61: 60-4; discussion 64-5. PMID: 17621019, DOI: 10.1227/01.neu.0000279724.05898.e7.Peer-Reviewed Original ResearchConceptsNontraumatic subarachnoid hemorrhageConvulsive status epilepticusNationwide Inpatient SampleSubarachnoid hemorrhageRenal diseaseStatus epilepticusInpatient SampleNonfederal United States hospitalsGeneralized convulsive status epilepticusDatabase of admissionsDuration of hospitalizationMultivariate logistic regressionUnited States hospitalsHospital mortalityHospital stayAdult patientsYounger patientsIndependent predictorsPatient mortalityEmergency departmentPatientsLinear regression analysisState HospitalNeurosurgical proceduresLogistic regression
2006
In Nonconvulsive Status Epilepticus (NCSE), Treat to Burst‐Suppression: Pro and Con
Jordan KG, Hirsch LJ. In Nonconvulsive Status Epilepticus (NCSE), Treat to Burst‐Suppression: Pro and Con. Epilepsia 2006, 47: 41-45. PMID: 17044825, DOI: 10.1111/j.1528-1167.2006.00659.x.Peer-Reviewed Original ResearchConceptsNonconvulsive status epilepticusNonconvulsive seizuresRefractory nonconvulsive status epilepticusPermanent neuronal injuryAcute brain injuryIntensive care interventionsHigh mortality rateNeuronal injuryStatus epilepticusIatrogenic complicationsBrain damageBrain injuryCare interventionsDr. HirschBurst suppressionMortality rateExpert managementSeizuresInjuryMost casesEpilepticusMedicationsComplicationsDr. Jordan