journal
https://read.qxmd.com/read/38513704/developing-systems-of-care-for-stroke-in-resource-limited-settings
#21
JOURNAL ARTICLE
Gisele Sampaio Silva, Eva Rocha
Although stroke prevention and treatment strategies have significantly advanced in recent years, implementation of these care elements in resource-limited settings can be challenging, since the burden of stroke is higher and access to stroke care is lower. Barriers to stroke care in resource-limited settings include insufficient prevention, reduced awareness of stroke symptoms, limited prehospital care and lack of triage systems, limited access to comprehensive stroke centers, inadequate personnel education, lack of staff and resources, as well as limited access to neuroimaging, thrombolytics, mechanical thrombectomy, neurosurgical care, and rehabilitation...
April 2024: Seminars in Neurology
https://read.qxmd.com/read/38499194/neurological-care-within-the-indian-health-service
#22
JOURNAL ARTICLE
Karen Parko, Michael Stitzer, Brian Trimble, Loretta Christensen
American Indians and Alaska Natives (AI/AN) are the Indigenous peoples of the United States. According to the U.S. Census Bureau, approximately 9.7 million people self-identified as AI/AN (alone or in combination with other races), representing 2.9% of the total U.S. population. These people represent diverse groups of discrete Tribes, each with their language, culture, and geographic home. As part of the conquest and settlement of North America, some Indigenous peoples signed treaties with the U.S. government, surrendering their lands in return for various government commitments, including health care...
April 2024: Seminars in Neurology
https://read.qxmd.com/read/38183975/updates-in-the-management-of-paraneoplastic-syndrome
#23
JOURNAL ARTICLE
Neha Verma, Muhammad H Jaffer, Avinash S Kolli, Sepideh Mokhtari
Paraneoplastic neurological syndromes (PNS) are defined as remote neurologic immune-mediated effects triggered by underlying systemic tumors. While recognizing specific syndromes can aid early cancer detection, overutilization of paraneoplastic assays in the absence of a classic syndrome can precipitate overdiagnosis and overtreatment. PNS involve autoantibodies targeting intracellular or extracellular antigens, with variable immunotherapy responses based on antigen type. Diagnosing PNS is challenging, requiring exclusion of other differential diagnoses...
February 2024: Seminars in Neurology
https://read.qxmd.com/read/38183974/neurologic-complications-in-adult-cancer-survivorship
#24
JOURNAL ARTICLE
Tresa Michelle McGranahan, Karl Cristie Figuracion, Myron Goldberg, David P Sheppard
Over the past decade, the improvement in cancer diagnostics and therapeutics has extended the overall survival of patients diagnosed with cancer including brain cancer. However, despite these unprecedented medical successes, patients continue to experience numerous neurologic complications after treatment that interfere with their independence, functionality, and overall quality of life. These include, among others, cognitive impairment, endocrinopathies, peripheral and cranial neuropathies, and vasculopathy...
February 2024: Seminars in Neurology
https://read.qxmd.com/read/38176424/management-of-neurologic-complications-in-patients-with-brain-and-spine-tumors
#25
REVIEW
Alipi V Bonm, Lynne P Taylor
Patients with brain and spine tumors represent a distinct population with unique needs. We provide a practical review of neurologic care in this group with an emphasis on familiarizing the general neurologist to the nuances of neuro-oncologic supportive care. We review the management of cerebral edema, steroid dosing, and pertinent side effects. We discuss seizure management, including choice of anticonvulsants, putative antitumor effects, and important seizure mimics like drop attacks. We review the presentation and symptomatology of stroke-like migraine attack after radiation therapy (SMART syndrome)...
February 2024: Seminars in Neurology
https://read.qxmd.com/read/38176423/palliative-care-in-neuro-oncology
#26
JOURNAL ARTICLE
Jessica M Besbris, Lynne P Taylor
Historically, the practice of neurology as an independent subspecialty from internal medicine began in Europe and the United States in the 1930s. The American Academy of Neurology (AAN) was founded 75 years ago in 1948, solidifying its emergence as a stand-alone discipline of medicine. In 1967, St. Christopher's Hospice, the first free standing hospice home, was opened in London by Dame Cicely Saunders. Dame Saunders is considered a pioneer in the development of the hospice movement, and she embodies the importance of the multi-disciplinary team in the care of the patient, as she began her career as a nurse, then became a social worker and, finally, a physician...
February 2024: Seminars in Neurology
https://read.qxmd.com/read/38158211/evolving-barriers-to-clinical-trial-enrollment-and-clinical-care-in-neuro-oncology-in-the-face-of-covid-19
#27
JOURNAL ARTICLE
Nikhil Grandhi, Alice Y Zhou, Margaret O Johnson, Omar H Butt
The lack of treatments with durable response in neuro-oncology highlights the critical need for clinical trials to advance patient care. The intersection of relatively low incidence, evolving classification schema, and entrenched community, healthcare provider, and organizational factors have been historic challenges against successful trial enrollment and implementation. The additional need for multidisciplinary, often tertiary-level care, further magnifies latent national and international health inequities with rural and under-served populations...
February 2024: Seminars in Neurology
https://read.qxmd.com/read/38096910/cancer-predisposition-syndromes-in-neuro-oncology
#28
REVIEW
Brian Na, Shilp Shah, Phioanh Leia Nghiemphu
Although most primary central and peripheral nervous system (NS) tumors occur sporadically, there are a subset that may arise in the context of a cancer predisposition syndrome. These syndromes occur due to a pathogenic mutation in a gene that normally functions as a tumor suppressor. With increased understanding of the molecular pathogenesis of these tumors, more people have been identified with a cancer predisposition syndrome. Identification is crucial, as this informs surveillance, diagnosis, and treatment options...
February 2024: Seminars in Neurology
https://read.qxmd.com/read/38052237/the-natural-history-and-treatment-of-meningiomas-an-update
#29
REVIEW
Arsene Daniel Nyalundja, Fabrice Mugisha, Claire Karekezi
Meningiomas are the most frequent nonmalignant tumors of the central nervous system (CNS). Despite their benign nature and slow-growing pattern, if not diagnosed early, these tumors may reach relatively large sizes causing significant morbidity and mortality. Some variants are located in hard-to-access locations, compressing critical neurovascular structures, and making the surgical management even more challenging. Although most meningiomas have a good long-term prognosis after treatment, there are still controversies over their management in a subset of cases...
February 2024: Seminars in Neurology
https://read.qxmd.com/read/38049116/neurorehabilitation-for-adults-with-brain-and-spine-tumors
#30
REVIEW
Hanna Hunter, Evelyn Qin, Allison Wallingford, April Hyon, Amar Patel
Central nervous system (CNS) malignancies (i.e. brain and spine tumors) and their treatments can result in a multitude of neurologic deficits. Patients with CNS malignancies experience physical, cognitive, and psychosocial sequelae that can impact their mobility and quality of life. Neurorehabilitation can play a critical role in maintaining independence, preventing disability, and optimizing safety with activities of daily living. This review provides an overview of the neurorehabilitation approaches for patients with CNS malignancies, neurologic impairments frequently treated, and rehabilitation interventions in various health care settings...
February 2024: Seminars in Neurology
https://read.qxmd.com/read/38183973/headache-management-in-individuals-with-brain-tumor
#31
JOURNAL ARTICLE
Ami Cuneo, Natalia Murinova
Headache occurs commonly in individuals diagnosed with cerebral neoplasm. Though the features of a brain tumor-associated headache may vary, a progressive nature of headache and a change in headache phenotype from a prior primary headache disorder often are identified. Pathophysiologic mechanisms proposed for headache associated with brain tumor include headache related to traction on pain-sensitive structures, activation of central and peripheral pain processes, and complications from surgical, chemotherapeutic and/or radiotherapy treatment(s)...
January 6, 2024: Seminars in Neurology
https://read.qxmd.com/read/38096849/neuro-oncology-treatment-strategies-for-primary-glial-tumors
#32
JOURNAL ARTICLE
Fernando Santos-Pinheiro, Jerome J Graber
Primary brain tumors underwent reclassification in the 2021 World Health Organization update, relying on molecular findings (especially isocitrate dehydrogenase mutations and chromosomal changes in 1p, 19q, gain of chromosome 7 and loss of chromosome 10). Newer entities have also been described including histone 3 mutant midline gliomas. These updated pathologic classifications improve prognostication and reliable diagnosis, but may confuse interpretation of prior clinical trials and require reclassification of patients diagnosed in the past...
December 2023: Seminars in Neurology
https://read.qxmd.com/read/38096848/neuro-oncology
#33
JOURNAL ARTICLE
Lynne P Taylor, Tresa M McGranahan, Vyshak Alva Venur
No abstract text is available yet for this article.
December 2023: Seminars in Neurology
https://read.qxmd.com/read/38011864/management-of-brain-metastases-a-review-of-novel-therapies
#34
REVIEW
Shreyas Bellur, Atulya Aman Khosla, Ahmad Ozair, Rupesh Kotecha, Michael W McDermott, Manmeet S Ahluwalia
Brain metastases (BMs) represent the most common intracranial tumors in adults, and most commonly originate from lung, followed by breast, melanoma, kidney, and colorectal cancer. Management of BM is individualized based on the size and number of brain metastases, the extent of extracranial disease, the primary tumor subtype, neurological symptoms, and prior lines of therapy. Until recently, treatment strategies were limited to local therapies, like surgical resection and radiotherapy, the latter in the form of whole-brain radiotherapy or stereotactic radiosurgery...
December 2023: Seminars in Neurology
https://read.qxmd.com/read/37995744/central-nervous-system-lymphoma
#35
REVIEW
Trusha Shah, Vyshak A Venur
Central nervous system lymphoma (CNSL) is a rare and aggressive malignancy that primarily affects the brain, spinal cord, and meninges. This article provides a comprehensive overview of the current understanding of CNSL encompassing its epidemiology, pathophysiology, clinical presentation, diagnosis, treatment modalities, and prognosis. Although the main focus is on primary CNS lymphoma (PCNSL), ocular lymphoma, primary leptomeningeal lymphoma, and secondary CNS lymphoma are also discussed. The pathobiology of CNSL involves the infiltration of malignant lymphocytes within the CNS parenchyma or leptomeninges...
December 2023: Seminars in Neurology
https://read.qxmd.com/read/37989214/leptomeningeal-carcinomatosis-from-solid-tumor-malignancies-treatment-strategies-and-biomarkers
#36
JOURNAL ARTICLE
Rachna Malani, Ankush Bhatia, Allison Betof Warner, Jonathan T Yang
Leptomeningeal metastases/diseases (LMDs) are a late-stage complication of solid tumor or hematologic malignancies. LMD is spread of cancer cells to the layers of the leptomeninges (pia and arachnoid maters) and subarachnoid space seen in 3 to 5% of cancer patients. It is a disseminated disease which carries with it significant neurologic morbidity and mortality. Our understanding of disease pathophysiology is currently lacking; however, advances are being made. As our knowledge of disease pathogenesis has improved, treatment strategies have evolved...
December 2023: Seminars in Neurology
https://read.qxmd.com/read/37963583/intracranial-germ-cell-tumors
#37
JOURNAL ARTICLE
Teri Danielle You Ying Yeoh, Vincent Nga, Miriam Kimpo, Simon S Lo, Balamurugan Vellayappan
Intracranial germ cell tumors are rare tumors occurring in adolescents and young adults, which include germinomas and non-germinomatous type germ cell tumors (NGGCT). In the past few decades, cooperative trial groups in Europe and North America have developed successful strategies to improve survival outcomes and decrease treatment-related toxicities. New approaches to establishing diagnosis have deferred the need for radical surgery. The 5-year event-free survival (EFS) is above 90% and even patients who present with metastatic germinoma can still be cured with chemotherapy and craniospinal irradiation...
December 2023: Seminars in Neurology
https://read.qxmd.com/read/37963582/surgical-management-and-advances-in-the-treatment-of-glioma
#38
REVIEW
Andrew A Hardigan, Joshua D Jackson, Anoop P Patel
The care of patients with both high-grade glioma and low-grade glioma necessitates an interdisciplinary collaboration between neurosurgeons, neuro-oncologists, neurologists and other practitioners. In this review, we aim to detail the considerations, approaches and advances in the neurosurgical care of gliomas. We describe the impact of extent-of-resection in high-grade and low-grade glioma, with particular focus on primary and recurrent glioblastoma. We address advances in surgical methods and adjunct technologies such as intraoperative imaging and fluorescence guided surgery that maximize extent-of-resection while minimizing the potential for iatrogenic neurological deficits...
December 2023: Seminars in Neurology
https://read.qxmd.com/read/37963581/brain-tumor-imaging-review-of-conventional-and-advanced-techniques
#39
REVIEW
Andrew Campion, Michael Iv
Approaches to central nervous system (CNS) tumor classification and evaluation have undergone multiple iterations over the past few decades, in large part due to our growing understanding of the influence of genetics on tumor behavior and our refinement of brain tumor imaging techniques. Computed tomography and magnetic resonance imaging (MRI) both play a critical role in the diagnosis and monitoring of brain tumors, although MRI has become especially important due to its superior soft tissue resolution. The purpose of this article will be to briefly review the fundamentals of conventional and advanced techniques used in brain tumor imaging...
December 2023: Seminars in Neurology
https://read.qxmd.com/read/37949117/classification-and-grading-of-central-nervous-system-tumors-according-to-the-world-health-organization-5th-edition
#40
JOURNAL ARTICLE
Rebecca A Yoda, Patrick J Cimino
The World Health Organization (WHO) released the 5th edition of its classification of central nervous system (CNS) tumors in 2021. Advances in the landscape of molecular tumor pathophysiology prompted major revisions to the previous edition released in 2016, some of which were first introduced by the Consortium to Inform Molecular and Practical Approaches to CNS Tumor Taxonomy-Not Official WHO (cIMPACT-NOW). The 2021 classification system integrates newly gained molecular insights to guide changes in tumor taxonomy and nomenclature, introduces several new types of tumors, and expands the use of molecular testing for diagnosis and grading, with a particular impact on adult-type and pediatric-type gliomas, ependymomas, and embryonal tumors...
December 2023: Seminars in Neurology
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