Reassessing hourly neurochecks

J Clin Neurosci. 2023 Apr:110:71-73. doi: 10.1016/j.jocn.2023.02.009. Epub 2023 Feb 21.

Abstract

Following acute brain injury, frequent neurological examinations ("neurochecks") are commonly prescribed and form the cornerstone of many care protocols and guidelines (e.g., for intracranial hemorrhage). While these assessments are intended to identify and mitigate secondary injury, they may unintentionally contribute to additional injury related to neurocheck-associated sleep disruption. Data are lacking to define patterns of neurological decline following acute brain injury, as are data to define the short- and long-term consequences (e.g., neuropsychological sequelae) of frequent and prolonged neurochecks. A critical need exists for rigorous evaluation of neurocheck practices, perceptions, benefits and risks, along with interventions to optimize neurocheck frequency and duration.

Keywords: ICU; Neuroassessment; Neurocheck; Neurocritical care; Neurological examination; Sleep disruption.

MeSH terms

  • Brain Injuries*
  • Critical Care / methods
  • Disease Progression
  • Humans
  • Intracranial Hemorrhages
  • Neurologic Examination / methods