دانلود کتاب اطلس EEG هیرش و برنر در مراقبت های حیاتی

The utilization of continuous EEG (cEEG) in critically ill patients has markedly expanded since the first edition of this atlas just over a decade ago. Multicenter collaborative efforts have determined that increases in seizure burden (including nonconvulsive seizures) are independent predictors of worse outcome in many different types of patients, as measured in many ways, including long-term functional outcome, cognition and later epilepsy. These efforts have also shown that even highly epileptiform patterns that do not qualify as seizures are sometimes sufficient to cause progressive neuronal injury, especially in the setting of an acute brain insult. For the vast majority of patients there is little clinical suggestion at the bedside that these patterns or seizures are present (other than impaired alertness), and thus cEEG has a crucial role in patient care. Centers have responded by incorporating new technology and designing highly specialized neuro-intensive care units with the capacity to record EEG at any time of the day, to detect seizures or potentially injurious EEG patterns, and rapidly feed this information back to treating clinicians to best inform management decisions. Continuous EEG has since become a routine part of caring for critically ill patients in many institutions around the world. As a result, neurologists and intensivists need to become familiar with the use of routine brain monitoring with EEG, or ‘neurotelemetry’, as they have with routine cardiovascular monitoring. The atlas begins with a section on the basics of EEG interpretation geared towards someone with minimal if any EEG experience (Chapters 1–2). The atlas follows with chapters on: EEG patterns seen in encephalopathy and coma – both nonspecific and specific (Chapter 3); focal abnormalities (Chapter 4); rhythmic and periodic patterns (RPPs), including detailed explanation of the recent American Clinical Neurophysiology Society (ACNS) standardized critical care EEG terminology guideline that was extensively updated in 2021 (Chapter 5); seizures and status epilepticus, including new definitions of electrographic and electroclinical seizures/status epilepticus (Chapter 6), and controversial patterns such as those on the ictal-interictal continuum (now defined); confusing artifacts, including ones that are often misinterpreted or that mimic seizures (Chapter 7); and patterns that are commonly seen post cardiac arrest (Chapter 8). After the above sections on raw EEG patterns from both a basic and advanced viewpoint, there is an extensive color section on prolonged continuous digital EEG monitoring, including quantitative EEG techniques to assist with interpretation of prolonged recordings (Chapters 9–10). These techniques can aid in efficient recognition of seizures, ischemia and other neurological events, and can help visualize long-term trends. This chapter also contains examples of multimodal brain monitoring in the neurocritical care setting. Throughout the atlas, EEG findings are highlighted and labeled in detail within the tracings themselves. Each chapter beginswith a short section of text and a list of the most important references as suggested reading. In general, the chapters progress from very basic material at the start of the chapter to more advanced. An appendix summarizing the 2021 ACNS terminology is included as well. There is an extensive index as well to help the reader rapidly find what they need.