CONTINUUM Lifelong Learning in Neurology最新文献_第6页

Intracerebral Hemorrhage. 脑内出血。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2026-06-01 Epub Date: 2026-06-03 DOI: 10.1212/cont.0000000000001713

Wendy C Ziai, Vishank A Shah

{"title":"Intracerebral Hemorrhage.","authors":"Wendy C Ziai, Vishank A Shah","doi":"10.1212/cont.0000000000001713","DOIUrl":"10.1212/cont.0000000000001713","url":null,"abstract":"Objective: This article reviews the most important concepts in primary and secondary prevention of spontaneous intracerebral hemorrhage (ICH), with an update on nuances of recovery and rehabilitation in survivors of ICH.Latest developments: We are in the era of population-based risk assessment with neuroimaging and other markers, with distinct goals of primary and secondary ICH prevention and a holistic approach to management strategies. It is important to recognize that ICH survivors are not only at higher risk of ICH recurrence but also of arterial ischemic events. Increasing, although still limited, data guide specific practice for the prevention of recurrent hemorrhage and ischemic events after ICH. New data indicate that recovery after ICH is significantly slower than seen in ischemic stroke, with patients demonstrating slow but steady improvement through 1 year postictus, underscoring the importance of long-term supportive care and rehabilitation.Essential points: The treatment of spontaneous ICH remains challenging, although hematoma volume and brain edema are becoming modifiable factors. Long-term favorable outcomes after ICH are possible even for patients with poor initial recovery in the hospital and are often influenced by in-hospital events after the acute phase. Secondary prevention is essential for the patient with ICH and requires an individualized evaluation and treatment approach, balancing the risks of future ICH recurrence with arterial ischemic events. Cognitive decline and mood disorders contribute significantly to health-related quality of life after ICH, in addition to functional impairment, and may require a broad range of interventions.","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"32 3","pages":"836-868"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151868","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

Transitional Stroke Care and the Road to Recovery. 过渡性中风护理和康复之路。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2026-06-01 Epub Date: 2026-06-03 DOI: 10.1212/cont.0000000000001706

Mona N Bahouth

{"title":"Transitional Stroke Care and the Road to Recovery.","authors":"Mona N Bahouth","doi":"10.1212/cont.0000000000001706","DOIUrl":"10.1212/cont.0000000000001706","url":null,"abstract":"Objective: Formalized stroke center care has improved morbidity and mortality from stroke, but transitional care after hospital discharge remains highly variable. This article provides a conceptual framework for transitional stroke care, summarizes data-driven practices, and reviews strategies for the successful implementation of programs that translate to success for patients and care partners.Latest developments: The ideal transitional stroke care framework is largely driven by protocolized care delivery models aimed at the conduct of efficient diagnostic processes, adherence to effective treatments, and avoidance of common poststroke complications. A large-scale randomized clinical trial testing an early-supported discharge program (COMPASS-TC [Comprehensive Post-Acute Stroke Services transitional care]) was significantly limited by poor uptake, with only 35% of enrolled participants completing the prescribed intervention visit at implementation sites. There have been numerous single-center reports of benefits for hospitalized patients with stroke when postdischarge transitional care is well coordinated. The Joint Stroke Transitional Technology-Enhanced Program, an example of a standardized early supported discharge program, is an interprofessional, specialty program composed of a series of joint telemedicine visits for hospitalized patients with stroke. Using this model has demonstrated high value with the rate of visit completion with the stroke specialist greater than 80%, accelerated access to recovery resources, and lower 30-day hospital readmission rates compared with national standards.Essential points: Based on a holistic conceptual framework, implementation of a formalized transitional stroke care model optimizes success for both the patient with stroke and the comprehensive stroke center of care.","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"32 3","pages":"886-901"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148152211","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

Issue Overview. 问题概述。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2026-06-01 Epub Date: 2026-06-03 DOI: 10.1212/01.cont.0001194432.18259.27

引用次数: 0

List of Abbreviations. 缩略语列表。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2026-06-01 Epub Date: 2026-06-03 DOI: 10.1212/cont.0000000000001717

引用次数: 0

Neurology's Action Potential: Delivering on the Promise of Brain Health. 神经学的动作电位：实现对大脑健康的承诺。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2026-06-01 Epub Date: 2026-06-03 DOI: 10.1212/cont.0000000000001742

Lyell K Jones

引用次数: 0

Learning Objectives and Core Competencies. 学习目标和核心竞争力。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2026-06-01 Epub Date: 2026-06-03 DOI: 10.1212/cont.0000000000001716

引用次数: 0

Pregnancy and Stroke Risk. 怀孕和中风风险。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2026-06-01 Epub Date: 2026-06-03 DOI: 10.1212/cont.0000000000001707

Michelle H Leppert

{"title":"Pregnancy and Stroke Risk.","authors":"Michelle H Leppert","doi":"10.1212/cont.0000000000001707","DOIUrl":"10.1212/cont.0000000000001707","url":null,"abstract":"Objective: This article reviews the epidemiology, pathophysiology, clinical management, and prevention strategies for pregnancy-related stroke, with a focus on recognizing risk factors, guiding acute treatment, and counseling for future pregnancies.Latest developments: Recent data highlight rising rates of pregnancy-related strokes, particularly among older maternal age groups, with increasing contributions from ischemic strokes and cerebral venous thrombosis. Advances in imaging safety, thrombolysis, and endovascular therapy now support their use in selected pregnant and postpartum patients. Low-dose aspirin, tighter blood pressure control, and preconception counseling have emerged as key strategies for stroke prevention, especially in women with hypertensive disorders of pregnancy or thrombophilia.Essential points: Stroke affects approximately 30 per 100,000 pregnancies, with risk peaking in the peripartum and postpartum periods. Physiologic changes during pregnancy, including hypercoagulability, venous stasis, and vascular injury, contribute to increased risk. Acute stroke therapies, including thrombolysis and endovascular thrombectomy, can be used safely in pregnant patients. Prevention efforts should focus on optimizing blood pressure, screening for thrombophilia, encouraging healthy lifestyle behaviors, and using low-dose aspirin in women at high risk.","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"32 3","pages":"746-774"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148152200","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 Large Artery Atherosclerosis. 大动脉粥样硬化的处理。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2026-06-01 Epub Date: 2026-06-03 DOI: 10.1212/cont.0000000000001712

Ashley M Wabnitz

{"title":"Management of Large Artery Atherosclerosis.","authors":"Ashley M Wabnitz","doi":"10.1212/cont.0000000000001712","DOIUrl":"10.1212/cont.0000000000001712","url":null,"abstract":"Objective: Large artery atherosclerosis is a common cause of ischemic stroke and transient ischemic attack and presents a high-risk condition for recurrent strokes. This article provides clinicians with current best practices in the diagnosis and management of large artery atherosclerosis.Latest developments: With an aging population and high prevalence of poorly controlled risk factors, the incidence of stroke due to atherosclerosis will continue to increase. Aggressive management of risk factors, including hypertension and hyperlipidemia, is an essential part of managing patients with stroke or transient ischemic attack due to large artery atherosclerosis. Dual antithrombotic therapy for secondary stroke prevention is recommended for more patients with large artery atherosclerosis than ever before. The role of revascularization, particularly for asymptomatic carotid disease, continues to be explored in the era of better medical management practices.Essential points: Preventing ischemic stroke in patients with large artery atherosclerosis is largely reliant on providers aggressively managing stroke risk factors, ensuring appropriate antithrombotic selection, and carefully selecting patients for revascularization.","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"32 3","pages":"869-885"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148152088","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

Thrombolysis, Thrombectomy, and Antithrombotic Therapy for Acute Ischemic Stroke. 急性缺血性脑卒中的溶栓、取栓和抗栓治疗。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2026-06-01 Epub Date: 2026-06-03 DOI: 10.1212/cont.0000000000001701

Christopher R Leon Guerrero

引用次数: 0

Infection Risk and Vaccine Considerations in Multiple Sclerosis and Related Disorders. 多发性硬化症和相关疾病的感染风险和疫苗考虑。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2026-04-01 Epub Date: 2026-04-02 DOI: 10.1212/cont.0000000000001697

Avindra Nath, Amit Bar-Or

{"title":"Infection Risk and Vaccine Considerations in Multiple Sclerosis and Related Disorders.","authors":"Avindra Nath, Amit Bar-Or","doi":"10.1212/cont.0000000000001697","DOIUrl":"10.1212/cont.0000000000001697","url":null,"abstract":"Objective: This article provides an overview of infections, their association with specific immunotherapies, preventive strategies, diagnostic features, and management in patients with multiple sclerosis and related disorders. It reviews current guidelines and provides a practical approach to vaccinations in this population.Latest developments: The spectrum of infections associated with the introduction of new immunotherapies is now being realized. For example, although fingolimod causes the most opportunistic infections, other drugs in this class have not been associated with similar infections; however, experience with them is also limited. Similarly, teriflunomide and dimethyl fumarate, previously considered relatively low risk, have now been associated with several infections. Evolving insights into vaccine responses in patients on immunotherapies have also helped inform discussions about their safety and utility. For example, although B-cell depletion with CD20-antibody therapies substantially reduces or even abrogates antibody responses to vaccines, the T-cell responses are quite robust, such that vaccination is still beneficial even if response cannot be documented with usual serologic testing.Essential points: Major advancements in the management of multiple sclerosis and related disorders with immunotherapies have also increased the risk for infections and raised questions about the need for and efficacy of vaccinations. Several types of infections can occur in individuals on immunotherapies; however, the vulnerability to infections depends on the specific class of treatment. Careful monitoring for infections and prompt investigations are necessary because atypical presentations and rapid progression may occur. Patient education is also key to early recognition of these infections. Immunotherapies can compromise the protective immune responses to vaccines; hence, timing the vaccines by giving them before starting or dosing of immunotherapies is important.","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"32 2","pages":"565-595"},"PeriodicalIF":0.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596286","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