CONTINUUM Lifelong Learning in Neurology

Nontraumatic intracerebral hemorrhage (ICH) is the second most common type of stroke. This article summarizes the basic pathophysiology, classification, and management of ICH and discusses the available evidence on therapy for hematoma, hematoma expansion, and perihematomal edema.

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Moderate and Severe Traumatic Brain Injury

Robinson, Christopher P. DO, MS

doi : 10.1212/CON.0000000000001036

Volume 27(5), October 2021, p 1278-1300

Traumatic brain injury (TBI) encompasses a group of heterogeneous manifestations of a disease process with high neurologic morbidity and, for severe TBI, high probability of mortality and poor neurologic outcomes. This article reviews TBI in neurocritical care, hence focusing on moderate and severe TBI, and includes an up-to-date review of the many variables to be considered in clinical care.

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Posterior Reversible Encephalopathy Syndrome and Reversible Cerebral Vasoconstriction Syndrome as Syndromes of Cerebrovascular Dysregulation

Singhal, Aneesh B. MD, FAAN, FANA, FAHA

doi : 10.1212/CON.0000000000001037

Volume 27(5), October 2021, p 1301-1320

This article describes the causes, clinical and imaging features, management, and prognosis of posterior reversible encephalopathy syndrome (PRES) and reversible cerebral vasoconstriction syndrome (RCVS), in which the underlying pathophysiology is related to reversible dysregulation of the cerebral vasculature.

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Seizures, Status Epilepticus, and Continuous EEG in the Intensive Care Unit

Rosenthal, Eric S. MD

doi : 10.1212/CON.0000000000001012

Volume 27(5), October 2021, p 1321-1343

This article discusses the evolving definitions of seizures and status epilepticus in the critical care environment and the role of critical care EEG in both diagnosing seizure activity and serving as a predictive biomarker of clinical trajectory.

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Neuromuscular Disorders in the Intensive Care Unit

Birch, Torrey Boland MD

doi : 10.1212/CON.0000000000001004

Volume 27(5), October 2021, p 1344-1364

This article discusses the pathophysiology, presentation, diagnosis, treatment, and prognosis of common neuromuscular disorders seen in the intensive care unit, including Guillain-Barre syndrome, myasthenia gravis, and intensive care unit-acquired weakness.

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Acute Neurologic Manifestations of Respiratory Viruses

Pizzi, Michael A. DO, PhD

doi : 10.1212/CON.0000000000001007

Volume 27(5), October 2021, p 1365-1381

Understanding the pathophysiology of COVID-19 and the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus that causes the disease has demonstrated the complexity of acute respiratory viruses that can cause neurologic manifestations. This article describes the most common respiratory viruses that have neurologic manifestations, with a focus on SARS-CoV-2 and COVID-19.

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Neurologic Complications in the Postoperative Neurosurgery Patient

Sarwal, Aarti MD, FNCS, FAAN, FCCM, RPNI

doi : 10.1212/CON.0000000000001039

Volume 27(5), October 2021, p 1382-1404

This article discusses neurologic complications encountered in the postoperative care of neurosurgical patients that are common or key to recognize in the immediate postoperative period. The major neurosurgical subspecialty procedures (cerebrovascular neurosurgery, neuro-oncology, epilepsy neurosurgery, functional neurosurgery, CSF diversion, endovascular neurosurgery, and spinal surgery) are broadly included under craniotomy procedures, endovascular/vascular procedures, and spinal procedures. This article focuses on the range of complications inherent in these approaches with specific scenarios addressed as applicable.

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Neurologic Outcome Prediction in the Intensive Care Unit

Maciel, Carolina B. MD, MSCR

doi : 10.1212/CON.0000000000001053

Volume 27(5), October 2021, p 1405-1429

The burden of severe and disabling neurologic injury on survivors, families, and society can be profound. Neurologic outcome prediction, or neuroprognostication, is a complex undertaking with many important ramifications. It allows patients with good prognoses to be supported aggressively, survive, and recover; conversely, it avoids inappropriate prolonged and costly care in those with devastating injuries.

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Palliative Care and Shared Decision Making in the Neurocritical Care Unit

Creutzfeldt, Claire J. MD

doi : 10.1212/CON.0000000000001003

Volume 27(5), October 2021, p 1430-1443

This article reviews the evidence on integrating palliative care into the care of patients with various types of serious neurologic illness, emphasizes the importance of palliative care in the neurocritical care unit, and suggests tools for clinicians to improve their communication skills and decision making.

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Brain Death/Death by Neurologic Criteria Determination

Lewis, Ariane MD; Kirschen, Matthew P. MD, PhD

doi : 10.1212/CON.0000000000000987

Volume 27(5), October 2021, p 1444-1464

This article describes the prerequisites for brain death/death by neurologic criteria (BD/DNC), clinical evaluation for BD/DNC (including apnea testing), use of ancillary testing, and challenges associated with BD/DNC determination in adult and pediatric patients.

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