Neurological Complications of Cardiac Procedures
Semin Neurol DOI: 10.1055/s-0041-1728761Neurological complications after cardiac surgery and percutaneous cardiac interventions are not uncommon. These include periprocedural stroke, postoperative cognitive dysfunction after cardiac surgery, contrast-induced encephalopathy after percutaneous interventions, and seizures. In this article, we review the incidence, pathophysiology, diagnosis, and management of these complications. Improved understanding of these complications could lead to their prevention, faster detection, and facilitation of diagnostic workup and appropriate treatment. [...] Thieme Medical Publishers, Inc. ...
Source: Seminars in Neurology - June 15, 2021 Category: Neurology Authors: Hrdlicka, Courtney M. Wang, Jeffrey Selim, Magdy Tags: Review Article Source Type: research
Myelopathy: A Clinical Approach
Semin Neurol DOI: 10.1055/s-0041-1725145Myelopathy is a clinical diagnosis with many causes. A focused history and neurologic exam can help identify a myelopathic syndrome that guides a targeted workup. Though an exact cause may not always be identified, a thoughtful clinical approach can narrow down the differential diagnosis enough to treat the patient. [...] Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents | Abstract | Full text (Source: Seminars in Neurology)
Source: Seminars in Neurology - June 1, 2021 Category: Neurology Authors: Bhai, Salman Bhattacharyya, Shamik Tags: Review Article Source Type: research
Myelopathies from Neoplasms
This article provides a systematic and practical review of neoplasms that can cause myelopathy. Unique imaging and biological features of distinct tumors are discussed, and their management strategies are reviewed. [...] Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents | Abstract | Full text (Source: Seminars in Neurology)
Source: Seminars in Neurology - May 24, 2021 Category: Neurology Authors: Lim-Fat, Mary Jane Dietrich, Jorg Tags: Review Article Source Type: research
Immune-Mediated Myelopathies: A Review of Etiologies, Diagnostic Approach, and Therapeutic Management
Semin Neurol DOI: 10.1055/s-0041-1725152Myelopathy is a broad term used to describe a heterogeneous group of disorders that affects the spinal cord; the focus of this article will be a subgroup of these disorders with an autoimmune and inflammatory-based pathology. Symptoms typically develop over hours or days and then worsen over a matter of days to weeks, but sometimes can have a more insidious or subacute presentation, which can make the diagnosis more puzzling. Despite relatively low incidence rates, almost a third of affected patients are left with severely disabling symptoms. Prompt recognition of the underlying etio...
Source: Seminars in Neurology - May 24, 2021 Category: Neurology Authors: Abdel-Wahed, Lama Cho, Tracey A. Tags: Review Article Source Type: research
Metabolic and Toxic Myelopathies
Semin Neurol DOI: 10.1055/s-0041-1725150Metabolic and toxic causes of myelopathy form a heterogeneous group of disorders. In this review, we discuss the causes of metabolic and toxic myelopathies with respect to clinical presentation, pathophysiology, diagnostic testing, treatment, and prognosis. This review is organized by temporal course (hyperacute, acute, subacute, and chronic) and etiology (e.g., nutritional deficiency, toxic exposure). Broadly, the myelopathies associated with dietary toxins (neurolathyrism, konzo) and decompression sickness present suddenly (hyperacute). The myelopathies associated with heroin use a...
Source: Seminars in Neurology - May 19, 2021 Category: Neurology Authors: Slama, Micha ël C. C. Berkowitz, Aaron L. Tags: Review Article Source Type: research
Imaging Considerations in Spinal Cord Evaluation
Semin Neurol DOI: 10.1055/s-0041-1725969Multiple diverse pathologies result in the clinical presentation of myelopathy. The preferred way to image the spinal cord depends on clinical history, anatomic site of interest, and patient issues limiting certain imaging modalities. This radiology-focused article discusses pertinent physiological considerations, reviews basic and newer imaging techniques, and examines several distinct disease entities in order to highlight the key role of imaging in the work-up of myelopathy. [...] Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thi...
Source: Seminars in Neurology - May 19, 2021 Category: Neurology Authors: Shea, Alice C. Kuo, Anderson H. Hsu, Liangge Tags: Review Article Source Type: research
Cervical and Thoracic Spondylotic Myelopathies
This article discusses our current understanding of the epidemiology, pathophysiology, clinical assessment, natural history, and treatment options in degenerative myelopathies of the cervical and thoracic spine. We additionally review diagnostic modalities including imaging modalities of the spine and neurophysiological tools such as electromyography/nerve conduction studies, somatosensory-evoked potentials, and motor-evoked potentials. Assessment instruments that can be used for the assessment of myelopathies are reviewed, including the Japanese Orthopedic Association (JOA) score, modified-JOA scale, Nurick scale, nine-ho...
Source: Seminars in Neurology - May 19, 2021 Category: Neurology Authors: Onofrei, Ligia V. Henrie, A. Michael Tags: Review Article Source Type: research
Traumatic Spinal Cord Disorders: Current Topics and Future Directions
Semin Neurol DOI: 10.1055/s-0041-1725125Traumatic spinal cord injury (tSCI) is a life-changing and potentially overwhelming event. The sudden disruption of the spinal cord's integrity necessitates rapid attention at a specialized medical center, and involves a multilateral collaboration between neurologists, spine surgeons, critical care physicians, and trauma specialists. Even with care under ideal conditions, many tSCI patients have significant disability that persists for the rest of their lives. However, recently, we have seen a proliferation in clinical and translational trials that offer the promise that new treatmen...
Source: Seminars in Neurology - May 19, 2021 Category: Neurology Authors: Huang, Kevin T. Lu, Yi Tags: Review Article Source Type: research
Vascular Spinal Cord Disorders
This article comprehensively reviews relevant spinal cord vascular anatomy, clinical features, radiographic findings, treatment, and prognosis of vascular disorders of the spinal cord. [...] Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents | Abstract | Full text (Source: Seminars in Neurology)
Source: Seminars in Neurology - May 19, 2021 Category: Neurology Authors: English, Stephen W. Zalewski, Nicholas L. Tags: Review Article Source Type: research
Infectious Myelopathies
Semin Neurol DOI: 10.1055/s-0041-1725126In the setting of both globalization and increasing use of immunosuppressive therapy, infectious myelopathies are an important cause of morbidity worldwide. Clinical spinal cord syndromes related to infection are varied, including transverse myelitis, acute flaccid paralysis related to anterior horn cell involvement, spinal cord compression, chronic spastic paraparesis, and myeloradiculitis. Causative pathogens include viruses, parasites, pyogenic and atypical bacteria, and fungi. The epidemiology, clinical characteristics, diagnosis, and treatment of selected organisms will be discu...
Source: Seminars in Neurology - May 19, 2021 Category: Neurology Authors: Anand, Pria Tags: Review Article Source Type: research
Prevalence, Mechanisms, and Management of Ischemic Stroke in Heart Failure Patients
Semin Neurol DOI: 10.1055/s-0041-1726329Heart failure (HF) and stroke, two of the major causes of death worldwide, are closely associated. Although atrial fibrillation (AF), which occurs in more than half of patients with HF, is a major risk factor for stroke, there is a great deal of evidence that HF itself increases the risk of stroke independent of AF. The main mechanism of stroke appears to be thromboembolism. However, previous studies have failed to demonstrate the benefit of warfarin in patients with HF without AF, as the benefit of stroke prevention was counteracted by the increased incidence of major bleeding. Rece...
Source: Seminars in Neurology - April 13, 2021 Category: Neurology Authors: Seol, Hyeyoung Kim, Jong S. Tags: Review Article Source Type: research
Neurological Complications in Patients with Heart Transplantation
This article provides a review of the diagnosis and management of neurological complications after cardiac transplantation. [...] Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents | Abstract | Full text (Source: Seminars in Neurology)
Source: Seminars in Neurology - April 13, 2021 Category: Neurology Authors: Sakusic, Amra Rabinstein, Alejandro A. Tags: Review Article Source Type: research
Cerebrovascular Complication and Valve Surgery in Infective Endocarditis
Semin Neurol DOI: 10.1055/s-0041-1726327Infective endocarditis (IE) with neurologic complications is common in patients with active IE. The most common and feared neurological complication of left-sided IE is cerebrovascular, from septic emboli causing ischemic stroke, intracranial hemorrhage (ICH), or an infectious intracranial aneurysm with or without rupture. In patients with cerebrovascular complications, valve replacement surgery is often delayed for concern of further neurological worsening. However, in circumstances when an indication for valve surgery to treat IE is present, the benefits of early surgical treatment...
Source: Seminars in Neurology - April 13, 2021 Category: Neurology Authors: Rice, Cory J. Kovi, Shivakrishna Wisco, Dolora R. Tags: Review Article Source Type: research
Atrial Fibrillation and Ischemic Stroke: A Clinical Review
Semin Neurol DOI: 10.1055/s-0041-1726332Atrial fibrillation (AF) is an important risk factor for ischemic stroke resulting in a fivefold increased stroke risk and a twofold increased mortality. Our understanding of stroke mechanisms in AF has evolved since the concept of atrial cardiopathy was introduced as an underlying pathological change, with both AF and thromboembolism being common manifestations and outcomes. Despite the strong association with stroke, there is no evidence that screening for AF in asymptomatic patients improves clinical outcomes; however, there is strong evidence that patients with embolic stroke of ...
Source: Seminars in Neurology - April 13, 2021 Category: Neurology Authors: Migdady, Ibrahim Russman, Andrew Buletko, Andrew B. Tags: Review Article Source Type: research
Cerebrovascular Disease and Cognitive Outcome in Patients with Cardiac Disease
Semin Neurol DOI: 10.1055/s-0041-1726330The pace of understanding cognitive decline and dementia has rapidly accelerated over the past decade, with constantly evolving insights into the vascular contributions to cognitive impairment and dementia (VCID). Notably, more overlap has been discovered in the pathophysiology between what was previously understood to be Alzheimer's disease and VCID, leading to a heightened emphasis on disease prevention through early and aggressive control of vascular risk factors. One particularly vulnerable population may be those with cardiac disease, as they are at risk for cerebrovascular dise...
Source: Seminars in Neurology - April 13, 2021 Category: Neurology Authors: Johansen, Michelle C. Gottesman, Rebecca F. Tags: Review Article Source Type: research
