Neurostorming in Brain Injury

Characteristics of Neurostorming

Neurostorming, also known as paroxysmal sympathetic hyperactivity (PSH), is characterized by episodes of tachycardia, hypertension, tachypnea, hyperthermia, diaphoresis, and posturing, according to Praxis Medical Insights 1
Symptoms of neurostorming typically occur in a paroxysmal pattern with periods of relative normalcy between episodes, as noted by Praxis Medical Insights 2
Episodes of neurostorming can be triggered by external stimuli such as repositioning, suctioning, or other care activities, as reported by Praxis Medical Insights 1

Hypoxic-ischemic brain injury can trigger neurostorming without diffuse axonal injury being present, as found in a study published in Circulation 3
Symptomatic hypoxic-ischemic injury with diffuse brain cell death can present with global neurological signs, according to the Journal of the American College of Cardiology 4
Focal traumatic lesions affecting autonomic centers or pathways can cause neurostorming, as noted by Praxis Medical Insights 2

Non-contrast CT is the first-line imaging modality in acute traumatic brain injury but has limitations in detecting both diffuse axonal injury and early signs of neurostorming, as stated by Praxis Medical Insights 1
MRI is indicated when CT results are normal but persistent unexplained neurologic findings are present, according to Praxis Medical Insights 1, 2

Management of neurostorming focuses on symptom control regardless of underlying etiology, as recommended by Praxis Medical Insights 2
Treatment strategies for neurostorming include maintaining adequate cerebral perfusion with systolic BP >110 mmHg, as suggested by Praxis Medical Insights 2
Controlling ventilation through intubation and mechanical ventilation when necessary is a treatment strategy for neurostorming, as noted by Praxis Medical Insights 2
Preventing secondary brain injury through avoidance of hypocapnia is a key aspect of neurostorming management, according to Praxis Medical Insights 2
Early physical therapy to prevent contractures is a recommended treatment strategy for neurostorming, as stated by Praxis Medical Insights 2