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Panayiotis N. Varelas, Dan Eastwood, Hyun J. Yun, Marianna V. Spanaki, Lotfi Hacein Bey, Christos Kessaris and Thomas A. Gennarelli

. Acad Emerg Med 11 : 1127 – 1134 , 2004 5 Diringer MN , Edwards DF : Admission to a neurologic/neurosurgical intensive care unit is associated with reduced mortality rate after intracerebral hemorrhage . Crit Care Med 29 : 635 – 640 , 2001 6 Ghajar J , Hariri RJ , Narayan RK , Iacono LA , Firlik K , Patterson RH : Survey of critical care management of comatose, head-injured patients in the United States . Crit Care Med 23 : 560 – 567 , 1995 7 Hanson CW III , Deutschman CS , Anderson HL III , Reilly PM

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Panayiotis N. Varelas, Lotfi Hacein-Bey, Lonni Schultz, Mary Conti, Marianna V. Spanaki and Thomas A. Gennarelli

of spontaneous intracerebral hemorrhage: a statement for healthcare professionals from a special writing group of the Stroke Council, American Heart Association . Stroke 30 : 905 – 915 , 1999 7 Campbell ML , Frank RR : Experience with an end-of-life practice at a university hospital . Crit Care Med 25 : 197 – 202 , 1997 8 Cook D , Rocker G , Marshall J , Sjokvist P , Dodek P , Griffith L , : Withdrawal of mechanical ventilation in anticipation of death in the intensive care unit . N Engl J Med 349 : 1123 – 1132 , 2003 9

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Thorsteinn Gunnarsson and Jan Hillman

The practice of modern neurointensive care is based on the use of multimodality monitoring to respond rapidly to physiological, biochemical, or morphological changes and avoid secondary brain injury. Until recently, one important monitoring method, computerized tomography (CT), has not been available for bedside use. The authors have over 3 years of experience with the routine use of bedside CT scanning and have developed their own method of scanning the patients in their beds. In this report, they describe three illustrative cases in which the mobile CT scanner was of great value in the management of difficult neurosurgical intensive care problems. It is concluded that the availability of bedside morphological monitoring in the neurosurgery intensive care unit is of great help in management and clinical decision making.

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Jesse D. Lawrence, Chad Tuchek, Aaron A. Cohen-Gadol and Raymond F. Sekula Jr.

contribution to statistical analysis; and to Glenda Shaw for her assistance with editing. References 1 Beauregard CL , Friedman WA : Routine use of postoperative ICU care for elective craniotomy: a cost-benefit analysis . Surg Neurol 60 : 483 – 489 , 489 , 2003 10.1016/S0090-3019(03)00517-2 14670660 2 Bui JQH , Mendis RL , van Gelder JM , Sheridan MMP , Wright KM , Jaeger M : Is postoperative intensive care unit admission a prerequisite for elective craniotomy? . J Neurosurg 115 : 1236 – 1241 , 2011 21888476 10.3171/2011.8.JNS11105 3 Charlson

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Era D. Mikkonen, Markus B. Skrifvars, Matti Reinikainen, Stepani Bendel, Ruut Laitio, Sanna Hoppu, Tero Ala-Kokko, Atte Karppinen and Rahul Raj

prognostic models based on large cohort of international patients . BMJ 336 : 425 – 429 , 2008 10.1136/bmj.39461.643438.25 18270239 14 Raj R , Bendel S , Reinikainen M , Hoppu S , Luoto T , Ala-Kokko T , : Traumatic brain injury patient volume and mortality in neurosurgical intensive care units: a Finnish nationwide study . Scand J Trauma Resusc Emerg Med 24 : 133 , 2016 10.1186/s13049-016-0320-6 27821129 15 Raj R , Siironen J , Skrifvars MB , Hernesniemi J , Kivisaari R : Predicting outcome in traumatic brain injury: development

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Chris S. Karas, Mirza N. Baig and Scott W. Elton

driven the technology involved in mobile CT scanning. Gunnarsson and associates 4 reported a successful reduction in both medical and technical complications as well as decreased staff workload in the intensive care unit setting with the introduction of mobile CT and the elimination of patient transport for imaging. 4 Our retrospective analysis of 19 neurosurgical operations performed in the OR and NICU makes a comparison of these two environments in an attempt to identify specific complications or benefits attributable to either location. In general we focused on

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Alexander C. Flint, Sheila L. Chan, Vivek A. Rao, Allen D. Efron, Maziyar A. Kalani and William F. Sheridan

bolt can be placed at the bedside in a monitored setting, such as the intensive care unit (ICU), and can therefore avoid use of the expensive and time-limited resource of the OR. Second, the SEPS procedure at the bedside is minimally invasive and does not involve general anesthesia. Previous small series have established the general safety of the SEPS procedure and have compared the performance characteristics of SEPS and bur hole drainage. However, the small sample sizes in studies published to date have not been sufficient to establish SEPS drainage as equivalent

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John Q. H. Bui, Rajith L. Mendis, James M. van Gelder, Mark M. P. Sheridan, Kylie M. Wright and Matthias Jaeger

Society held in Adelaide, Australia, on November 19, 2010. References 1 Ashkan K , Edwards RJ , Bell BA : Crisis in resources: a neurosurgical prospective . Br J Neurosurg 15 : 342 – 346 , 2001 2 Beauregard CL , Friedman WA : Routine use of postoperative ICU care for elective craniotomy: a cost-benefit analysis . Surg Neurol 60 : 483 – 489 , 2003 3 Jaeger M , Schuhmann MU , Samii M , Rickels E : Neurosurgical emergencies and missing neurosurgical intensive care unit capacity: is “operate-and-return” a sound policy? . Eur J

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Darryl Lau, Cecilia L. Dalle Ore, Phiroz E. Tarapore, Michael Huang, Geoffrey Manley, Vineeta Singh, Praveen V. Mummaneni, Michael Beattie, Jacqueline Bresnahan, Adam R. Ferguson, Jason F. Talbott, William Whetstone and Sanjay S. Dhall

, protocol-driven intensive care unit (ICU) management, and surgical intervention, they can obtain acceptable outcomes, especially those who present with mild neurological deficits. 29 , 32 Even patients presenting with functionally complete SCI can benefit from early surgical intervention. 5 Prompt operative management of SCI has been shown to be associated with a lower mortality rate, even after adjusting for differences in age, sex, and comorbidities; however, it can also be associated with higher rates of complications than nonoperative management. 6 , 14 , 21 , 35

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W. Lee Titsworth, Jeannette Hester, Tom Correia, Richard Reed, Miranda Williams, Peggy Guin, A. Joseph Layon, Lennox K. Archibald and J Mocco

Spinal Cord Med 24 : 101 – 104 , 2001 18 Horan TC , Andrus M , Dudeck MA : CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting . Am J Infect Control 36 : 309 – 332 , 2008 19 Huang WC , Wann SR , Lin SL , Kunin CM , Kung MH , Lin CH , : Catheter-associated urinary tract infections in intensive care units can be reduced by prompting physicians to remove unnecessary catheters . Infect Control Hosp Epidemiol 25 : 974 – 978 , 2004 20 Jain P