Episode 13: Intracerebral hemorrhage and elevated ICP (part 1)

In this episode of Critical Care Scenarios, Brandon Odo and Brian Bolling delve into neurocritical care, focusing on a case involving a 56-year-old male admitted to the ICU with right-sided weakness, altered mental status, and a left frontotemporal intracranial hemorrhage. They discuss initial assessment, including neurological exams and reviewing CT scans, and emphasize the importance of stabilizing the patient and consulting with neurosurgery. The conversation covers managing the patient's blood pressure, reversing anticoagulation from apixaban use, and considering interventions for elevated intracranial pressure, such as hyperosmolar therapy and potential EVD placement. They address the challenges of neurological assessments in intubated patients and the tiered approach to managing elevated ICP, adjusting treatment based on the patient's evolving condition and lab results while awaiting further interventions from the neurosurgery team.