CONTINUUM Lifelong Learning in Neurology最新文献_第3页

Emergent Management of Intracerebral Hemorrhage. 脑出血的紧急处理。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2024-06-01 DOI: 10.1212/CON.0000000000001422

Santosh B Murthy

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Neuroinfectious Emergencies. 神经感染急症。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2024-06-01 DOI: 10.1212/CON.0000000000001425

Alexandra S Reynolds

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Neuro-oncologic Emergencies. 神经肿瘤急症

CONTINUUM Lifelong Learning in Neurology Pub Date : 2024-06-01 DOI: 10.1212/CON.0000000000001435

Carolina B Maciel, Katharina M Busl

{"title":"Neuro-oncologic Emergencies.","authors":"Carolina B Maciel, Katharina M Busl","doi":"10.1212/CON.0000000000001435","DOIUrl":"10.1212/CON.0000000000001435","url":null,"abstract":"Objective: Neuro-oncologic emergencies have become more frequent as cancer remains one of the leading causes of death in the United States, second only to heart disease. This article highlights key aspects of epidemiology, diagnosis, and management of acute neurologic complications in primary central nervous system malignancies and systemic cancer, following three thematic classifications: (1) complications that are anatomically or intrinsically tumor-related, (2) complications that are tumor-mediated, and (3) complications that are treatment-related.Latest developments: The main driver of mortality in patients with brain metastasis is systemic disease progression; however, intracranial hypertension, treatment-resistant seizures, and overall decline due to increased intracranial burden of disease are the main factors underlying neurologic-related deaths. Advances in the understanding of tumor-specific characteristics can better inform risk stratification of neurologic complications. Following standardized grading and management algorithms for neurotoxic syndromes related to newer immunologic therapies is paramount to achieving favorable outcomes.Essential points: Neuro-oncologic emergencies span the boundaries of subspecialties in neurology and require a broad understanding of neuroimmunology, neuronal hyperexcitability, CSF flow dynamics, intracranial compliance, and neuroanatomy.","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141238818","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}

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ERRATUM. 错误。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2024-06-01 DOI: 10.1212/CON.0000000000001446

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Issue Overview. 问题概述。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2024-06-01 DOI: 10.1212/01.CON.0001024620.88362.74

引用次数: 0

Emergent Management of Spontaneous Subarachnoid Hemorrhage. 自发性蛛网膜下腔出血的紧急处理。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2024-06-01 DOI: 10.1212/CON.0000000000001428

Soojin Park

{"title":"Emergent Management of Spontaneous Subarachnoid Hemorrhage.","authors":"Soojin Park","doi":"10.1212/CON.0000000000001428","DOIUrl":"10.1212/CON.0000000000001428","url":null,"abstract":"Objective: Spontaneous subarachnoid hemorrhage (SAH) carries high morbidity and mortality rates, and the emergent management of this disease can make a large impact on patient outcome. The purpose of this article is to provide a pragmatic overview of the emergent management of SAH.Latest developments: Recent trials have influenced practice around the use of antifibrinolytics, the timing of aneurysm securement, the recognition of cerebral edema and focus on avoiding a lower limit of perfusion, and the detection and prevention of delayed cerebral ischemia. Much of the acute management of SAH can be protocolized, as demonstrated by two updated guidelines published by the American Heart Association/American Stroke Association and the Neurocritical Care Society in 2023. However, the gaps in evidence lead to clinical equipoise in some aspects of critical care management.Essential points: In acute management, there is an urgency to differentiate the etiology of SAH and take key emergent actions including blood pressure management and coagulopathy reversal. The critical care management of SAH is similar to that of other acute brain injuries, with the addition of detecting and treating delayed cerebral ischemia. Strategies for the detection and treatment of delayed cerebral ischemia are limited by disordered consciousness and may be augmented by monitoring and imaging technology.","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141238807","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

Prognostication in Neurocritical Care. 神经重症监护中的预诊。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2024-06-01 DOI: 10.1212/CON.0000000000001433

Susanne Muehlschlegel

{"title":"Prognostication in Neurocritical Care.","authors":"Susanne Muehlschlegel","doi":"10.1212/CON.0000000000001433","DOIUrl":"10.1212/CON.0000000000001433","url":null,"abstract":"Objective: This article synthesizes the current literature on prognostication in neurocritical care, identifies existing challenges, and proposes future research directions to reduce variability and enhance scientific and patient-centered approaches to neuroprognostication.Latest developments: Patients with severe acute brain injury often lack the capacity to make their own medical decisions, leaving surrogate decision makers responsible for life-or-death choices. These decisions heavily rely on clinicians' prognostication, which is still considered an art because of the previous lack of specific guidelines. Consequently, there is significant variability in neuroprognostication practices. This article examines various aspects of neuroprognostication. It explores the cognitive approach to prognostication, highlights the use of statistical modeling such as Bayesian models and machine learning, emphasizes the importance of clinician-family communication during prognostic disclosures, and proposes shared decision making for more patient-centered care.Essential points: This article identifies ongoing challenges in the field and emphasizes the need for future research to ameliorate variability in neuroprognostication. By focusing on scientific methodologies and patient-centered approaches, this research aims to provide guidance and tools that may enhance neuroprognostication in neurocritical care.","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141238819","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

Neurocritical Care and the Death of Therapeutic Nihilism. 神经重症监护与治疗虚无主义的消亡。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2024-06-01 DOI: 10.1212/CON.0000000000001460

Lyell K Jones

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Key Points for Issue. 问题要点。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2024-06-01 DOI: 10.1212/01.CON.0001023508.89865.f6

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SELF-ASSESSMENT AND CME. 自我评估和 CME。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2024-06-01 DOI: 10.1212/CON.0000000000001443

引用次数: 0