CONTINUUM Lifelong Learning in Neurology最新文献

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Key Points for Issue. 问题要点。
CONTINUUM Lifelong Learning in Neurology Pub Date : 2023-12-01 DOI: 10.1212/01.CON.0000997800.90946.b2
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引用次数: 0
SELF-ASSESSMENT AND CME. 自我评估和 CME。
CONTINUUM Lifelong Learning in Neurology Pub Date : 2023-12-01 DOI: 10.1212/CON.0000000000001369
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引用次数: 0
SELF-ASSESSMENT AND CME. 自我评估和 CME。
CONTINUUM Lifelong Learning in Neurology Pub Date : 2023-12-01 DOI: 10.1212/CON.0000000000001369
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引用次数: 0
Skull Base Tumors. 颅底肿瘤
CONTINUUM Lifelong Learning in Neurology Pub Date : 2023-12-01 DOI: 10.1212/CON.0000000000001361
Deborah A Forst, Pamela S Jones
{"title":"Skull Base Tumors.","authors":"Deborah A Forst, Pamela S Jones","doi":"10.1212/CON.0000000000001361","DOIUrl":"10.1212/CON.0000000000001361","url":null,"abstract":"<p><strong>Objective: </strong>This article reviews the presenting features, molecular characteristics, diagnosis, and management of selected skull base tumors, including meningiomas, vestibular schwannomas, pituitary neuroendocrine tumors, craniopharyngiomas, chordomas, ecchordosis physaliphora, chondrosarcomas, esthesioneuroblastomas, and paragangliomas.</p><p><strong>Latest developments: </strong>Skull base tumors pose a management challenge given their complex location and, as a result, the tumors and treatment can result in significant morbidity. In most cases, surgery, radiation therapy, or both yield high rates of disease control, but the use of these therapies may be limited by the surgical accessibility of these tumors and their proximity to critical structures. The World Health Organization classification of pituitary neuroendocrine tumors was updated in 2022. Scientific advances have led to an enhanced understanding of the genetic drivers of many types of skull base tumors and have revealed several potentially targetable genetic alterations. This information is being leveraged in the design of ongoing clinical trials, with the hope of rendering these challenging tumors treatable through less invasive and morbid measures.</p><p><strong>Essential points: </strong>Tumors involving the skull base are heterogeneous and may arise from bony structures, cranial nerves, the meninges, the sinonasal tract, the pituitary gland, or embryonic tissues. Treatment often requires a multidisciplinary approach, with participation from radiation oncologists, medical oncologists, neuro-oncologists, and surgical specialists, including neurosurgeons, otolaryngologists, and head and neck surgeons. Treatment has largely centered around surgical resection, when feasible, and the use of first-line or salvage radiation therapy, with chemotherapy, targeted therapy, or both considered in selected settings. Our growing understanding of the molecular drivers of these diseases may facilitate future expansion of pharmacologic options to treat skull base tumors.</p>","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"29 6","pages":"1752-1778"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138812882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Management of Complications in Neuro-oncology Patients. 神经肿瘤患者并发症的处理。
CONTINUUM Lifelong Learning in Neurology Pub Date : 2023-12-01 DOI: 10.1212/CON.0000000000001359
Mary R Welch
{"title":"Management of Complications in Neuro-oncology Patients.","authors":"Mary R Welch","doi":"10.1212/CON.0000000000001359","DOIUrl":"10.1212/CON.0000000000001359","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this article is to familiarize the reader with the spectrum of neurologic and medical complications relevant to the care of patients with neurologic cancer while highlighting best practices to prevent morbidity and mortality. Topics include tumor-related epilepsy, vasogenic edema, complications of corticosteroid use, disruption of the hypothalamic-pituitary axis, venous thromboembolism, and opportunistic infection.</p><p><strong>Latest developments: </strong>In 2021, a joint guideline from the Society for Neuro-Oncology and the European Association of Neuro-Oncology reaffirmed recommendations first established in 2000 that patients with newly diagnosed brain tumors should not be prescribed an antiseizure medication prophylactically. For those with tumor-related epilepsy, monotherapy with a non-enzyme-inducing anticonvulsant is the preferred initial treatment, and levetiracetam remains the preferred first choice. Surveys of physician practice continue to demonstrate excessive use of glucocorticoids in the management of patients with both primary and metastatic central nervous system malignancy. This is particularly concerning among patients who require checkpoint inhibitors as the efficacy of these agents is blunted by concomitant glucocorticoid use, resulting in a reduction in overall survival. Finally, direct oral anticoagulants have been shown to be safe in patients with brain tumors and are now favored as first-line treatment among those who require treatment for venous thromboembolism.</p><p><strong>Essential points: </strong>Medical care for patients impacted by primary and secondary central nervous system malignancy is complex and requires a committed team-based approach that routinely calls upon the expertise of physicians across multiple fields. Neurologists have an important role to play and should be familiar with the spectrum of complications impacting these patients as well as the latest recommendations for management.</p>","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"29 6","pages":"1844-1871"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138812867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Learning Objectives and Core Competencies. 学习目标和核心能力。
CONTINUUM Lifelong Learning in Neurology Pub Date : 2023-12-01 DOI: 10.1212/CON.0000000000001365
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引用次数: 0
SELF-ASSESSMENT AND CME. 自我评估和 CME。
CONTINUUM Lifelong Learning in Neurology Pub Date : 2023-12-01 DOI: 10.1212/CON.0000000000001369
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引用次数: 0
List of Abbreviations. 缩写表。
CONTINUUM Lifelong Learning in Neurology Pub Date : 2023-12-01 DOI: 10.1212/01.CON.0000998100.13454.35
{"title":"List of Abbreviations.","authors":"","doi":"10.1212/01.CON.0000998100.13454.35","DOIUrl":"10.1212/01.CON.0000998100.13454.35","url":null,"abstract":"","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"29 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138812865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Adult-type Diffuse Gliomas. 成人型弥漫性胶质瘤。
CONTINUUM Lifelong Learning in Neurology Pub Date : 2023-12-01 DOI: 10.1212/CON.0000000000001352
Macarena I de la Fuente
{"title":"Adult-type Diffuse Gliomas.","authors":"Macarena I de la Fuente","doi":"10.1212/CON.0000000000001352","DOIUrl":"10.1212/CON.0000000000001352","url":null,"abstract":"<p><strong>Objective: </strong>This article highlights key aspects of the diagnosis and management of adult-type diffuse gliomas, including glioblastomas and IDH-mutant gliomas relevant to the daily practice of the general neurologist.</p><p><strong>Latest developments: </strong>The advances in molecular characterization of gliomas have translated into more accurate prognostication and tumor classification. Gliomas previously categorized by histological appearance solely as astrocytomas or oligodendrogliomas are now also defined by molecular features. Furthermore, ongoing clinical trials have incorporated these advances to tailor more effective treatments for specific glioma subtypes.</p><p><strong>Essential points: </strong>Despite recent insights into the molecular aspects of gliomas, these tumors remain incurable. Care for patients with these complex tumors requires a multidisciplinary team in which the general neurologist has an important role. Efforts focus on translating the latest data into more effective therapies that can prolong survival.</p>","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"29 6","pages":"1662-1679"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138812856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Learning Objectives and Core Competencies. 学习目标和核心能力。
CONTINUUM Lifelong Learning in Neurology Pub Date : 2023-12-01 DOI: 10.1212/CON.0000000000001365
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引用次数: 0
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