Neurogenic Pulmonary Edema Caused by Subarachnoid Hemorrhage: A Case Report

Neurogenic pulmonary edema is a serious and life-threatening complication caused by central nervous system diseases, excluding cardiogenic pulmonary edema, other causes of pulmonary edema, lung injury, etc. The lack of specific diagnostic criteria for NPE and the lack of awareness among clinicians often lead to underdiagnosis and misdiagnosis. The disease progresses rapidly with poor prognosis and high mortality [1]. In this paper, we report a patient with a ruptured right middle cerebral artery aneurysm causing subarachnoid hemorrhage, who developed neurogenic pulmonary edema and underwent elective aneurysm clamping under general anesthesia. The relevant perioperative management is reported as follows, and the anesthesia management of patients with neurogenic pulmonary edema is analyzed in the context of the relevant literature.

Survey among Russian doctors on routine electroencephalography

The aim of the work was to assess how accurately specialists, performing EEG, apply the recommendations in their daily practice.Materials and Methods. An anonymous survey was conducted of 210 specialists in functional diagnostics and neurologists performing routine electroencephalography. The survey consisted of nine mandatory single-choice questions.Results. Only 9 respondents out of 210 (4.3%) perform routine EEG completely in accordance with the Recommendations of the Expert Council of Neurophysiology of the Russian Anti-Epileptic League on performing the routine EEG.' Of these, only three specialists (1.4% of the total number of respondents) answered that a functional diagnostics doctor is present throughout the entire examination.Conclusion: Despite the wide distribution and extensive experience in the use of EEG, there is no uniform practice of its implementation by doctors in the Russian Federation. Standardization of the methodology of its performance will increase confidence in EEG results among doctors of clinical specialties, increase the degree of inter-expert agreement among functional diagnostics physicians, and improve the quality of diagnosis of central nervous system diseases. To do this, it is necessary to develop webinar and educational programs on the methodology of EEG under the auspices of professional associations of doctors of functional diagnostics, neurophysiologists, neurologists.

Role of the Cholinergic Anti-Inflammatory Reflex in Central Nervous System Diseases

In several central nervous system diseases, it has been reported that inflammation may be related to the etiologic process, therefore, therapeutic strategies are being implemented to control inflammation. As the nervous system and the immune system maintain close bidirectional communication in physiological and pathological conditions, the modulation of inflammation through the cholinergic anti-inflammatory reflex has been proposed. In this review, we summarized the evidence supporting chemical stimulation with cholinergic agonists and vagus nerve stimulation as therapeutic strategies in the treatment of various central nervous system pathologies, and their effect on inflammation.

Microglial Phenotypic Transition: Signaling Pathways and Influencing Modulators Involved in Regulation in Central Nervous System Diseases

Microglia are macrophages that reside in the central nervous system (CNS) and belong to the innate immune system. Moreover, they are crucially involved in CNS development, maturation, and aging; further, they are closely associated with neurons. In normal conditions, microglia remain in a static state. Upon trauma or lesion occurrence, microglia can be activated and subsequently polarized into the pro-inflammatory or anti-inflammatory phenotype. The phenotypic transition is regulated by numerous modulators. This review focus on the literature regarding the modulators and signaling pathways involved in regulating the microglial phenotypic transition, which are rarely mentioned in other reviews. Hence, this review provides molecular insights into the microglial phenotypic transition, which could be a potential therapeutic target for neuroinflammation.