Evidence-Based Protocols in Child Neurology
This article shall focus on the current treatment guidelines used for inpatient pediatric neurology. (Source: Neurologic Clinics)
Source: Neurologic Clinics - June 9, 2021 Category: Neurology Authors: James J. Riviello, Jennifer Erklauer Source Type: research
Acute Coma
An acutely comatose patient constitutes a medical emergency until proved otherwise. Managing these emergencies requires organized teamwork to recognize and treat life-threatening situations and reversible causes of coma. Once vital functions have been stabilized, information from the history and physical examination should be used to rationally guide subsequent testing. Identifying causes of coma for which emergency treatment is possible should be the priority. The treatment and prognosis depend on the cause. (Source: Neurologic Clinics)
Source: Neurologic Clinics - April 23, 2021 Category: Neurology Authors: Amra Sakusic, Alejandro A. Rabinstein Source Type: research
Headache Emergencies
Headache is a common reason for seeking medical attention. Most cases are benign primary headache disorders; however, there is significant overlap between symptoms of these disorders and secondary headaches. Differentiating these clinical scenarios requires a careful history with attention to red flag symptoms and a neurologic examination. These details can identify dangerous disorders: subarachnoid hemorrhage, reversible cerebral vasoconstriction syndrome, elevated intracranial pressure, hydrocephalus, cerebral venous sinus thrombosis, arterial dissection, central nervous system infection, and inflammatory vasculitis. Old...
Source: Neurologic Clinics - April 23, 2021 Category: Neurology Authors: David Kopel, Crandall Peeler, Shuhan Zhu Source Type: research
Evaluation and Management of Seizures and Status Epilepticus
Seizures are frequently triggered by an inciting event and result from uninhibited excitation and/or decreased inhibition of a pool of neurons. If physiologic seizure abortive mechanisms fail, the ensuing unrestrained synchronization of neurons —status epilepticus—can be life-threatening and is associated with the potential for marked morbidity in survivors and high medical care costs. Prognosis is intimately related to etiology and its response to therapeutic measures. Timely implementation of pharmacologic therapy while concurrently performing a stepwise workup for etiology are paramount. Neurodiagnostic testing shou...
Source: Neurologic Clinics - April 23, 2021 Category: Neurology Authors: Pouya Alexander Ameli, Abdalla A. Ammar, Kent A. Owusu, Carolina B. Maciel Source Type: research
Neuromuscular Respiratory Failure
Neuromuscular respiratory failure can result from any disease that causes weakness of bulbar and/or respiratory muscles. Once compensatory mechanisms are overwhelmed, hypoxemic and hypercapnic respiratory failure ensues. The diagnosis of neuromuscular respiratory failure is primarily clinical, but arterial blood gases, bedside spirometry, and diaphragmatic ultrasonography can help in early assessment. Intensive care unit (ICU) admission is indicated for patients with severe bulbar weakness or rapidly progressing appendicular weakness. Intubation should be performed electively, particularly in patients with dysautonomia. Pa...
Source: Neurologic Clinics - April 23, 2021 Category: Neurology Authors: Tarun D. Singh, Eelco F.M. Wijdicks Source Type: research
Acute Myelopathy
Vascular and infectious causes are rare but important causes of spinal cord injury. High suspicion for these processes is necessary, as symptoms may progress over hours to days, resulting in delayed presentation and diagnosis and worse outcomes. History and clinical examination findings can assist with localization of the affected vascular territory and spinal level, which will assist with focusing spinal imaging. Open and/or endovascular surgical management depends on the associated vascular abnormality. Infectious myelopathy treatment consists of targeted antimicrobial therapy when possible, infectious source control, an...
Source: Neurologic Clinics - April 23, 2021 Category: Neurology Authors: Caleb R. McEntire, Richard S. Dowd, Emanuele Orru ’, Carlos David, Juan E. Small, Anna Cervantes-Arslanian, David P. Lerner Source Type: research
Emergency Care of Patients with Acute Ischemic Stroke
Stroke is a leading cause of morbidity and mortality and a major cause of long-term disability. Management of acute ischemic stroke in the first hours is critical to patient outcomes. This review provides an overview of acute ischemic stroke management, with a focus on the golden hour. Additional topics discussed include prehospital considerations and initial evaluation of the patient with history, examination, and imaging as well as treatment options, including thrombolysis and endovascular therapy. (Source: Neurologic Clinics)
Source: Neurologic Clinics - April 23, 2021 Category: Neurology Authors: Adeel S. Zubair, Kevin N. Sheth Source Type: research
Neurological Emergencies During Pregnancy
This article serves as a comprehensive review of neurologic emergencies in pregnancy. Common initial presentations of neuroemergencies are reviewed with a clinical algorithm. Neurovascular disorders in pregnancy are reviewed, including acute ischemic strokes with data on tPA and thrombectomy; cerebral venous sinus thrombosis diagnosis and management; posterior reversible encephalopathy syndrome management; reversible cerebral vasoconstriction syndrome; and intracerebral hemorrhage. Attention is paid to management of cerebral edema and safety of osmotic therapies. A review of seizures in pregnancy is provided, including new...
Source: Neurologic Clinics - April 23, 2021 Category: Neurology Authors: Elizabeth Macri, Diana Greene-Chandos Source Type: research
Bringing Order to the Chaos of Neurologic Emergencies Amid the Chaos of a Pandemic
Successfully caring for patients with neurologic emergencies presents significant challenges. The rapidity with which the emergency must be handled and the necessarily deliberate nature of the neurology involved are difficult to reconcile. The difficulty is compounded by the unforgiving nature of the injured nervous system and rapidly increasing body of knowledge about the conditions that cause these emergencies. Yet, the challenge is welcome. These patients are vulnerable, and our ability to meaningfully treat many previously devastating neurologic emergencies has improved dramatically in recent years. (Source: Neurologic Clinics)
Source: Neurologic Clinics - April 23, 2021 Category: Neurology Authors: Joseph D. Burns, Anna M. Cervantes-Arslanian Tags: Preface Source Type: research
Neurologic Emergencies
NEUROLOGIC CLINICS (Source: Neurologic Clinics)
Source: Neurologic Clinics - April 23, 2021 Category: Neurology Authors: Joseph D. Burns, Anna M. Cervantes-arslanian Source Type: research
Copyright
ELSEVIER (Source: Neurologic Clinics)
Source: Neurologic Clinics - April 23, 2021 Category: Neurology Source Type: research
Contributors
RANDOLPH W. EVANS, MD (Source: Neurologic Clinics)
Source: Neurologic Clinics - April 23, 2021 Category: Neurology Source Type: research
Contents
Joseph D. Burns and Anna M. Cervantes-Arslanian (Source: Neurologic Clinics)
Source: Neurologic Clinics - April 23, 2021 Category: Neurology Source Type: research
Forthcoming Issues
Pediatric Neurology (Source: Neurologic Clinics)
Source: Neurologic Clinics - April 23, 2021 Category: Neurology Source Type: research
Neuromonitoring After Cardiac Arrest
This article reviews the pathophysiology of hypoxic-ischemic brain injury, provides an overview of the neuromonitoring tools available to identify risk profiles for secondary brain injury, and highlights the importance of an individualized approach to post cardiac arrest care. (Source: Neurologic Clinics)
Source: Neurologic Clinics - March 31, 2021 Category: Neurology Authors: Rachel Beekman, Carolina B. Maciel, Ramani Balu, David M. Greer, Emily J. Gilmore Source Type: research
