North Shore-LIJ’s Brain Specialist Gregory Kapinos, MD, MS First-Authors Editorial Review of Published Study in Neurology
Contact: Michelle Pipia-Stiles
Gregory Kapinos, MD, MS, brain injury specialist and neurointensivist at North Shore-LIJ’s Cushing Neuroscience Institute (CNI), has written an editorial review of a published study in one of the most-widely read and highly-cited peer-reviewed journal, Neurology (July 9, 2013).
“Cliniocoradiologic Acute Monitoring After Intracerebral Hemorrhage: Toward Standards?” co-authored by Gregory Kapinos, MD, MS and J. Claude Hemphill, MD, MAS from University of California, San Francisco praises a study from Northwestern University entitled, “Surveillance Neuroimaging and Neurologic Examinations Affect Care for Intracerebral Hemorrhage.”
Intracerebral hemorrhages (ICH), also known as “brain bleeds,” can be devastating. The most common cause of deep bleeds into the brain is high blood pressure. Patients with small bleeds can survive and be left with minimal disability, but moderate and larger ones should be monitored closely in a dedicated neurologic intensive care unit to detect, and potentially reverse, any "second hit" injury.
In the editorial review by Dr. Kapinos and Dr. Hemphill, they commented on the need to further study the best way of performing surveillance of ICH patients with clinical examinations by doctors and nurses, along with repeated computed tomography (CT) scans.
In the Northwestern study, about 10 percent of patients had a delayed worsening condition, detected with exams and CT scans. These patients were rushed to the operating room to relieve pressure on the brain by means of drains or opening the skull. Dr. Kapinos and Dr. Hemphill reviewed the evidence for the need for serial clinical exams and radiology testing in these patients. They appraised and constructively criticized the Northwestern study and proposed some new ways of improving surveillance methods and building an international standard protocol.
Dr. Kapinos suggested analyzing the frequency and modality of neuroimaging techniques, as well as scrutinizing the need for different frequency and depth of clinical examinations. Dr. Kapinos is working on devising a comprehensive, but succinct, neurological examination (also known as “neurochecks”) for best surveillance of victims of all types of severe acute brain injury. His work will be presented at the upcoming World Federation of Neurosurgical Societies international congress in Seoul, Korea, this fall.
For the complete editorial review and Northwestern study, go to neurology.org.
For more information about the Neurocritical Care Center at North Shore-LIJ’s Cushing Neuroscience Institute, click here.