Neuropalliative Care in Severe Acute Brain Injury and Stroke.

Résumé

OBJECTIVE: Severe acute brain injury, including stroke, traumatic brain injury, and hypoxic-ischemic injury, presents acute and longitudinal challenges. This article emphasizes the need for holistic, long-term care and communication for patients and their care partners. It explores the multifaceted journey of survivors of severe acute brain injury and highlights the critical components required for effective management and support.LATEST DEVELOPMENTS: Recent advancements in the acute treatment of severe acute brain injury have significantly improved survival rates and reduced mortality. However, these advancements have also led to a growing population of survivors facing long-term challenges.ESSENTIAL POINTS: Severe acute brain injury accounts for millions of deaths and disabilities annually. Severe acute brain injury presents significant challenges in the hyperacute period and should also be viewed as a lifelong condition requiring continuous support across the range of goals of care, from curative and restorative to palliative and end-of-life care. Addressing total pain involves managing physical symptoms and providing emotional, social, and spiritual support to enhance quality of life for patients and their families. Accurate diagnosis and informed treatment decisions are crucial, involving a multidisciplinary team and comprehensive care plans. Effective communication of prognosis and goals-of-care conversations are essential for preparing patients and families for the future. Compassionate care focusing on comfort and quality of life in the final stages is critical, with clear communication about end-of-life preferences.