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

Emergent Management of Hypoxic-Ischemic Brain Injury. 缺氧缺血性脑损伤的紧急处理。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2024-06-01 DOI: 10.1212/CON.0000000000001426

Alexis Steinberg

{"title":"Emergent Management of Hypoxic-Ischemic Brain Injury.","authors":"Alexis Steinberg","doi":"10.1212/CON.0000000000001426","DOIUrl":"10.1212/CON.0000000000001426","url":null,"abstract":"Objective: This article outlines interventions used to improve outcomes for patients with hypoxic-ischemic brain injury after cardiac arrest.Latest developments: Emergent management of patients after cardiac arrest requires prevention and treatment of primary and secondary brain injury. Primary brain injury is minimized by excellent initial resuscitative efforts. Secondary brain injury prevention requires the detection and correction of many pathophysiologic processes that may develop in the hours to days after the initial arrest. Key physiologic parameters important to secondary brain injury prevention include optimization of mean arterial pressure, cerebral perfusion, oxygenation and ventilation, intracranial pressure, temperature, and cortical hyperexcitability. This article outlines recent data regarding the treatment and prevention of secondary brain injury. Different patients likely benefit from different treatment strategies, so an individualized approach to treatment and prevention of secondary brain injury is advisable. Clinicians must use multimodal sources of data to prognosticate outcomes after cardiac arrest while recognizing that all prognostic tools have shortcomings.Essential points: Neurologists should be involved in the postarrest care of patients with hypoxic-ischemic brain injury to improve their outcomes. Postarrest care requires nuanced and patient-centered approaches to the prevention and treatment of primary and secondary brain injury and neuroprognostication.","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"30 3","pages":"588-610"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141238736","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

The Neurocritical Care Examination and Workup. 神经重症监护检查和评估。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2024-06-01 DOI: 10.1212/CON.0000000000001438

Sarah Wahlster, Nicholas J Johnson

{"title":"The Neurocritical Care Examination and Workup.","authors":"Sarah Wahlster, Nicholas J Johnson","doi":"10.1212/CON.0000000000001438","DOIUrl":"10.1212/CON.0000000000001438","url":null,"abstract":"Objective: This article provides an overview of the evaluation of patients in neurocritical care settings and a structured approach to recognizing and localizing acute neurologic emergencies, performing a focused examination, and pursuing workup to identify critical findings requiring urgent management.Latest developments: After identifying and stabilizing imminent threats to survival, including respiratory and hemodynamic compromise, the initial differential diagnosis for patients in neurocritical care is built on a focused history and clinical examination, always keeping in mind critical \"must-not-miss\" pathologies. A key priority is to identify processes warranting time-sensitive therapeutic interventions, including signs of elevated intracranial pressure and herniation, acute neurovascular emergencies, clinical or subclinical seizures, infections of the central nervous system, spinal cord compression, and acute neuromuscular respiratory failure. Prompt neuroimaging to identify structural abnormalities should be obtained, complemented by laboratory findings to assess for underlying systemic causes. The indication for EEG and lumbar puncture should be considered early based on clinical suspicion.Essential points: In neurocritical care, the initial evaluation is often fast paced, requiring assessment and management to happen in parallel. History, clinical examination, and workup should be obtained while considering therapeutic implications and the need for lifesaving interventions.","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"30 3","pages":"556-587"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141238822","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 : 2024-04-01 DOI: 10.1212/CON.0000000000001406

引用次数: 0

Issue Overview. 问题概述。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2024-04-01 DOI: 10.1212/01.CON.0001011740.88650.d1

引用次数: 0

Key Points for Issue. 问题要点。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2024-04-01 DOI: 10.1212/01.CON.0001011016.27676.55

引用次数: 0

List of Abbreviations. 缩写表。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2024-04-01 DOI: 10.1212/01.CON.0001011736.96341.c8

引用次数: 0

List of Abbreviations. 缩写表。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2024-04-01 DOI: 10.1212/01.CON.0001011736.96341.c8

引用次数: 0

SELF-ASSESSMENT AND CME. 自我评估和 CME。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2024-04-01 DOI: 10.1212/CON.0000000000001381

引用次数: 0

SELF-ASSESSMENT AND CME. 自我评估和 CME。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2024-04-01 DOI: 10.1212/CON.0000000000001381

引用次数: 0

Headache in Children and Adolescents. 儿童和青少年头痛。

CONTINUUM Lifelong Learning in Neurology Pub Date : 2024-04-01 DOI: 10.1212/CON.0000000000001414

Serena L Orr

{"title":"Headache in Children and Adolescents.","authors":"Serena L Orr","doi":"10.1212/CON.0000000000001414","DOIUrl":"https://doi.org/10.1212/CON.0000000000001414","url":null,"abstract":"Objective: This article reviews the assessment of children and adolescents presenting with headache, provides an overview of primary headache disorders, and reviews evidence-based management of headache in this age group.Latest developments: In the last few years, new epidemiological data have shed light on less common pediatric headache disorders (eg, pediatric trigeminal autonomic cephalalgias) and psychosocial risk factors associated with primary headache disorders in children and adolescents. There has also recently been a substantial increase in interventions that target the calcitonin gene-related peptide pathway and that treat primary headache disorders using noninvasive neuromodulation. Although these interventions have primarily been studied in adults, there is emerging evidence of their use in the pediatric population.Essential points: Primary headache disorders are very common in youth, and the most commonly encountered headache diagnosis in neurology practice is migraine, which affects approximately 10% of children and adolescents. Diagnosing and effectively treating primary headache disorders before adulthood may have a sustained impact on the patient by improving long-term headache and mental health outcomes, thereby significantly reducing the burden of disability over time. There are several available and emerging acute and preventive interventions for youth with primary headache disorders, and treatment decisions should be made in the context of available evidence using a shared decision-making approach.","PeriodicalId":52475,"journal":{"name":"CONTINUUM Lifelong Learning in Neurology","volume":"30 2","pages":"438-472"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140870371","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