Evidence-Based Guidelines for the Management of Large Hemispheric Infarction: A Statement for Health Care Professionals from the Neurocritical Care Society and the German Society for Neuro-Intensive Care and Emergency Medicine

Michel T. Torbey, Julian Bösel, Denise H. Rhoney, Fred Rincon, Dimitre Staykov, Arun P. Amar, Panayiotis N. Varelas, Eric Jüttler, DaiWai W. Olson, Hagen B. Huttner, Klaus Zweckberger, Kevin N. Sheth, Christian Dohmen, Ansgar Brambrink, Stephan A. Mayer, Osama O. Zaidat, Werner Hacke, Stefan Schwab

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

Large hemispheric infarction (LHI), also known as malignant middle cerebral infarction, is a devastating disease associated with significant disability and mortality. Clinicians and family members are often faced with a paucity of high quality clinical data as they attempt to determine the most appropriate course of treatment for patients with LHI, and current stroke guidelines do not provide a detailed approach regarding the day-to-day management of these complicated patients. To address this need, the Neurocritical Care Society organized an international multidisciplinary consensus conference on the critical care management of LHI. Experts from neurocritical care, neurosurgery, neurology, interventional neuroradiology, and neuroanesthesiology from Europe and North America were recruited based on their publications and expertise. The panel devised a series of clinical questions related to LHI, and assessed the quality of data related to these questions using the Grading of Recommendation Assessment, Development and Evaluation guideline system. They then developed recommendations (denoted as strong or weak) based on the quality of the evidence, as well as the balance of benefits and harms of the studied interventions, the values and preferences of patients, and resource considerations.

Original languageEnglish (US)
Pages (from-to)146-164
Number of pages19
JournalNeurocritical Care
Volume22
Issue number1
DOIs
StatePublished - 2015

Fingerprint

Emergency Medicine
Critical Care
Infarction
Guidelines
Delivery of Health Care
Patient Preference
Cerebral Infarction
Neurosurgery
Neurology
North America
Publications
Consensus
Stroke
Mortality
Data Accuracy
Therapeutics

Keywords

  • Cerebral edema
  • Critical care management
  • Hemicraniectomy
  • Large hemispheric infarction
  • Large malignant stroke

ASJC Scopus subject areas

  • Clinical Neurology
  • Critical Care and Intensive Care Medicine

Cite this

Evidence-Based Guidelines for the Management of Large Hemispheric Infarction : A Statement for Health Care Professionals from the Neurocritical Care Society and the German Society for Neuro-Intensive Care and Emergency Medicine. / Torbey, Michel T.; Bösel, Julian; Rhoney, Denise H.; Rincon, Fred; Staykov, Dimitre; Amar, Arun P.; Varelas, Panayiotis N.; Jüttler, Eric; Olson, DaiWai W.; Huttner, Hagen B.; Zweckberger, Klaus; Sheth, Kevin N.; Dohmen, Christian; Brambrink, Ansgar; Mayer, Stephan A.; Zaidat, Osama O.; Hacke, Werner; Schwab, Stefan.

In: Neurocritical Care, Vol. 22, No. 1, 2015, p. 146-164.

Research output: Contribution to journalArticle

Torbey, MT, Bösel, J, Rhoney, DH, Rincon, F, Staykov, D, Amar, AP, Varelas, PN, Jüttler, E, Olson, DW, Huttner, HB, Zweckberger, K, Sheth, KN, Dohmen, C, Brambrink, A, Mayer, SA, Zaidat, OO, Hacke, W & Schwab, S 2015, 'Evidence-Based Guidelines for the Management of Large Hemispheric Infarction: A Statement for Health Care Professionals from the Neurocritical Care Society and the German Society for Neuro-Intensive Care and Emergency Medicine', Neurocritical Care, vol. 22, no. 1, pp. 146-164. https://doi.org/10.1007/s12028-014-0085-6
Torbey, Michel T. ; Bösel, Julian ; Rhoney, Denise H. ; Rincon, Fred ; Staykov, Dimitre ; Amar, Arun P. ; Varelas, Panayiotis N. ; Jüttler, Eric ; Olson, DaiWai W. ; Huttner, Hagen B. ; Zweckberger, Klaus ; Sheth, Kevin N. ; Dohmen, Christian ; Brambrink, Ansgar ; Mayer, Stephan A. ; Zaidat, Osama O. ; Hacke, Werner ; Schwab, Stefan. / Evidence-Based Guidelines for the Management of Large Hemispheric Infarction : A Statement for Health Care Professionals from the Neurocritical Care Society and the German Society for Neuro-Intensive Care and Emergency Medicine. In: Neurocritical Care. 2015 ; Vol. 22, No. 1. pp. 146-164.
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abstract = "Large hemispheric infarction (LHI), also known as malignant middle cerebral infarction, is a devastating disease associated with significant disability and mortality. Clinicians and family members are often faced with a paucity of high quality clinical data as they attempt to determine the most appropriate course of treatment for patients with LHI, and current stroke guidelines do not provide a detailed approach regarding the day-to-day management of these complicated patients. To address this need, the Neurocritical Care Society organized an international multidisciplinary consensus conference on the critical care management of LHI. Experts from neurocritical care, neurosurgery, neurology, interventional neuroradiology, and neuroanesthesiology from Europe and North America were recruited based on their publications and expertise. The panel devised a series of clinical questions related to LHI, and assessed the quality of data related to these questions using the Grading of Recommendation Assessment, Development and Evaluation guideline system. They then developed recommendations (denoted as strong or weak) based on the quality of the evidence, as well as the balance of benefits and harms of the studied interventions, the values and preferences of patients, and resource considerations.",
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T2 - A Statement for Health Care Professionals from the Neurocritical Care Society and the German Society for Neuro-Intensive Care and Emergency Medicine

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AU - Bösel, Julian

AU - Rhoney, Denise H.

AU - Rincon, Fred

AU - Staykov, Dimitre

AU - Amar, Arun P.

AU - Varelas, Panayiotis N.

AU - Jüttler, Eric

AU - Olson, DaiWai W.

AU - Huttner, Hagen B.

AU - Zweckberger, Klaus

AU - Sheth, Kevin N.

AU - Dohmen, Christian

AU - Brambrink, Ansgar

AU - Mayer, Stephan A.

AU - Zaidat, Osama O.

AU - Hacke, Werner

AU - Schwab, Stefan

PY - 2015

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N2 - Large hemispheric infarction (LHI), also known as malignant middle cerebral infarction, is a devastating disease associated with significant disability and mortality. Clinicians and family members are often faced with a paucity of high quality clinical data as they attempt to determine the most appropriate course of treatment for patients with LHI, and current stroke guidelines do not provide a detailed approach regarding the day-to-day management of these complicated patients. To address this need, the Neurocritical Care Society organized an international multidisciplinary consensus conference on the critical care management of LHI. Experts from neurocritical care, neurosurgery, neurology, interventional neuroradiology, and neuroanesthesiology from Europe and North America were recruited based on their publications and expertise. The panel devised a series of clinical questions related to LHI, and assessed the quality of data related to these questions using the Grading of Recommendation Assessment, Development and Evaluation guideline system. They then developed recommendations (denoted as strong or weak) based on the quality of the evidence, as well as the balance of benefits and harms of the studied interventions, the values and preferences of patients, and resource considerations.

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