CONTINUUM Lifelong Learning in Neurology最新文献_第5页

Bridging the Gap Between Brain Health Guidelines and Real-world Implementation. 弥合大脑健康指南和现实世界实施之间的差距。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2025-06-01 DOI: 10.1212/cont.0000000000001579

Daniel José Correa, Justin T Jordan, Rana R Said

{"title":"Bridging the Gap Between Brain Health Guidelines and Real-world Implementation.","authors":"Daniel José Correa, Justin T Jordan, Rana R Said","doi":"10.1212/cont.0000000000001579","DOIUrl":"10.1212/cont.0000000000001579","url":null,"abstract":"Abstract: With the increase in the public's attention to all aspects of brain health, neurologists need to understand their role in raising awareness, advocating for preventive strategies, and promoting brain health for all. This article examines the literature on the physical, mental, cognitive, and social health factors in promoting optimal brain function. In addition, it reviews various modifiable risk factors for neurologic injury, including cardiovascular health, nutrition, sleep, mental health, cognitive engagement, social interaction, and brain injury prevention. In all clinical neuroscience specialties, neurologists should adopt preventive approaches that consider brain health throughout the lifespan. This strategy includes attention to the significant impact of social determinants of health on disparities in brain health and neurologic disorders, underscoring the need for targeted interventions to promote health equity. To achieve brain health equity, neurologists must integrate culturally sensitive care approaches, develop adapted assessment tools, improve professional and public educational materials, and continually innovate interventions to meet the diverse needs of our communities. Achieving brain health for all will require a collaborative multilevel approach to promote and sustain preventive brain health initiatives through individual empowerment, community-based programs, and the integration of brain health into health care policies and practices.","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"31 3","pages":"865-884"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210158","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

Clinical Features and Diagnosis of Idiopathic Intracranial Hypertension. 特发性颅内高压的临床特征与诊断。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2025-06-01 DOI: 10.1212/cont.0000000000001570

Aileen A Antonio

引用次数: 0

Clinical Features and Diagnosis of Spontaneous Intracranial Hypotension. 自发性颅内低血压的临床特征与诊断。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2025-06-01 DOI: 10.1212/cont.0000000000001566

Jill C Rau, Jeremy K Cutsforth-Gregory

{"title":"Clinical Features and Diagnosis of Spontaneous Intracranial Hypotension.","authors":"Jill C Rau, Jeremy K Cutsforth-Gregory","doi":"10.1212/cont.0000000000001566","DOIUrl":"10.1212/cont.0000000000001566","url":null,"abstract":"Objective: This article reviews the current understanding of the varied clinical presentations of spontaneous intracranial hypotension and discusses strategies and limitations in diagnosing this complex syndrome, including approaches for medical practitioners outside of specialty centers.Latest developments: Radiologic algorithms applied to brain MRI (eg, the Bern score) can help assess the probability of an underlying spinal CSF leak, but they do not replace good history-taking and clinical acumen. Brain MRI findings may evolve over time with or without leak-directed treatment. New techniques and improvements in imaging technology have led to better identification and classification of different types of spinal CSF leaks, especially CSF-venous fistulas that were reported for the first time in 2014 and now account for 50% or more of the leaks in patients without spinal extradural fluid collections. Occasionally, spontaneous intracranial hypotension is the result of preexisting intracranial hypertension causing \"blowout\" leaks.Essential points: Spontaneous intracranial hypotension is caused by leakage of CSF from the spinal dura and most often presents with orthostatic headache, frequently accompanied by neck pain and stiffness, nausea, vestibulo-auditory distortions, visual changes, and other symptoms. Spontaneous intracranial hypotension can be debilitating, and long diagnostic and treatment delays are common. In rare cases, spontaneous intracranial hypotension can have dangerous sequelae, including superficial siderosis, subdural hematoma, bibrachial amyotrophy, brain sagging dementia, and even death. Early recognition of clinical symptoms and radiologic signs is imperative for best patient outcomes.","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"31 3","pages":"644-667"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210162","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

List of Abbreviations. 缩略语列表。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2025-06-01 DOI: 10.1212/01.cont.0001118472.70428.75

引用次数: 0

CONTRIBUTORS. 贡献者。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2025-06-01 DOI: 10.1212/CON.0000000000001572

引用次数: 0

SELF-ASSESSMENT AND CME. 自我评估和继续教育。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2025-06-01 DOI: 10.1212/cont.0000000000001583

引用次数: 0

Radiographic Evaluation of Normal Pressure Hydrocephalus. 正常压力性脑积水的影像学评价。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2025-06-01 DOI: 10.1212/cont.0000000000001577

Petrice Cogswell, Aaron Switzer

{"title":"Radiographic Evaluation of Normal Pressure Hydrocephalus.","authors":"Petrice Cogswell, Aaron Switzer","doi":"10.1212/cont.0000000000001577","DOIUrl":"10.1212/cont.0000000000001577","url":null,"abstract":"Objective: Normal pressure hydrocephalus (NPH) is a clinical syndrome of a gait disorder, cognitive impairment, and urinary incontinence that also has characteristic imaging features. This article provides an overview of the radiographic evaluation and imaging features of NPH.Latest developments: Ventriculomegaly is an overarching imaging feature of NPH, although it is nonspecific. More specific imaging features have been described in association with NPH subtypes. Patients with idiopathic NPH commonly have features of ventriculomegaly, high-convexity tight sulci, and enlarged sylvian fissures. Patients with delayed-onset congenital NPH have features of marked ventriculomegaly, without extraventricular hydrocephalus, and may have stenosis or obstruction of the cerebral aqueduct. Evaluation of CSF dynamics, patterns of radiotracer uptake on positron emission tomography (PET), and patterns of brain stiffness on MR elastography can help to differentiate idiopathic NPH from secondary NPH or a neurodegenerative process.Essential points: Imaging features of disproportionately enlarged subarachnoid space hydrocephalus are important to recognize as they are part of the diagnostic criteria for idiopathic NPH and aid in differentiating NPH from a neurodegenerative process. Evaluation of CSF dynamics, patterns of fludeoxyglucose (FDG) uptake, and patterns of brain stiffness may aid in the evaluation of challenging cases that lack typical clinical and structural radiographic features.","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"31 3","pages":"813-839"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210169","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

Radiographic Evaluation of Spontaneous Intracranial Hypotension. 自发性颅内低血压的影像学评价。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2025-06-01 DOI: 10.1212/cont.0000000000001567

Ajay A Madhavan, J Levi Chazen

引用次数: 0

Treatment of Spinal CSF Leaks and Fistulas. 脊髓液漏及瘘管的治疗。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2025-06-01 DOI: 10.1212/cont.0000000000001568

Narayan R Kissoon, Thien J Huynh

{"title":"Treatment of Spinal CSF Leaks and Fistulas.","authors":"Narayan R Kissoon, Thien J Huynh","doi":"10.1212/cont.0000000000001568","DOIUrl":"10.1212/cont.0000000000001568","url":null,"abstract":"Objective: The options for treatment of spontaneous spinal CSF leaks and CSF-venous fistulas have expanded in recent years, and this article reviews the current treatments available, factors that affect treatment outcomes, and an algorithmic approach to treatment.Latest developments: Until recently, treatments for spontaneous intracranial hypotension consisted of supportive care, epidural blood patching, and when the site of CSF leakage was known, surgical repair. CSF-venous fistulas are now known to be common causes of CSF hypotension and are rarely cured by epidural blood patching. Better visualization of CSF-venous fistulas and the novel treatment of CSF-venous fistulas with transvenous embolization have expanded the arsenal of treatment options for spontaneous intracranial hypotension.Essential points: Clinical outcomes improve with timely treatment of spinal CSF leaks and CSF-venous fistulas. Radiographic features direct treatment, which includes epidural blood patching, transvenous embolization, and surgical correction. CSF-venous fistulas respond poorly to epidural blood patching but can respond favorably to surgical obliteration or transvenous embolization.","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"31 3","pages":"688-708"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210131","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

Treatment and Monitoring of Idiopathic Intracranial Hypertension. 特发性颅内高压的治疗和监测。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2025-06-01 DOI: 10.1212/cont.0000000000001586

John J Chen, Susan P Mollan

{"title":"Treatment and Monitoring of Idiopathic Intracranial Hypertension.","authors":"John J Chen, Susan P Mollan","doi":"10.1212/cont.0000000000001586","DOIUrl":"10.1212/cont.0000000000001586","url":null,"abstract":"Objective: This article reviews the management of idiopathic intracranial hypertension (IIH), which is essential to neurology practice.Latest developments: The incidence and prevalence of IIH have risen because of the worldwide obesity epidemic. Evidence suggests that IIH has a unique systemic metabolic phenotype. Clinical history, examination, and visual fields remain the cornerstone for monitoring people with IIH. Optical coherence tomography demonstrates structural changes that aid decision-making. The principles of IIH management include protecting vision and escalating to surgical interventions when it is threatened, addressing the role of obesity in the condition, and providing advice on headache therapeutics. There are no labeled therapies for IIH; however, acetazolamide remains the most common medication prescribed. A glucagon-like peptide-1 receptor agonist was recently shown to reduce intracranial pressure independent of weight reduction in a phase II randomized controlled trial in people with IIH, suggesting it could be a promising treatment for IIH. In patients with IIH requiring surgery, there has been an increase in venous sinus stenting.Essential points: Neurologists are central in the management pathway for people with IIH. Ongoing coordinated care between ophthalmologists and neurologists is essential for optimal care of these patients.","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"31 3","pages":"728-756"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210173","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