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Continuum: Lifelong Learning in Neurology

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https://www.readbyqxmd.com/read/28157760/patient-management-problem-preferred-responses
#1
Kevin M Barrett
No abstract text is available yet for this article.
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28157759/patient-management-problem
#2
Kevin M Barrett
No abstract text is available yet for this article.
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28157755/coding-in-stroke-and-other-cerebrovascular-diseases
#3
Pearce J Korb, William Jones
Accurate coding is critical for clinical practice and research. Ongoing changes to diagnostic and billing codes require the clinician to stay abreast of coding updates. Payment for health care services, data sets for health services research, and reporting for medical quality improvement all require accurate administrative coding. This article provides an overview of coding principles for patients with strokes and other cerebrovascular diseases and includes an illustrative case as a review of coding principles in a patient with acute stroke...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28157754/remote-evaluation-of-the-patient-with-acute-stroke
#4
Bart M Demaerschalk
This article describes advances related to the successful remote evaluation of the patient with acute stroke. Telestroke is a connected care approach that brings expert stroke care to remote, neurologically underserved urban or rural locations. Recent findings reveal strong evidence showing that telestroke is equivalent to in-person care. Time is critical in treating patients with acute stroke, and telestroke networks must assure that technology improves-not delays-delivery of care. The stroke center and the spoke site must work collaboratively to develop and institute protocols and policies to ensure that eligible patients are identified, assessed, and treated swiftly...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28157753/discussing-life-sustaining-therapy-with-surrogate-decision-makers
#5
David Y Hwang
Clinicians caring for patients with severe stroke in intensive care units often grapple with requests from surrogate decision makers for life-prolonging treatment that members of the care team may believe to be futile. An example is a surrogate decision maker's request to place a tracheostomy and feeding tube in a patient who, in the clinical judgment of the neurocritical care team, is very unlikely to recover interactive capacity. This article presents a case, discusses definitions of medical futility, and summarizes recommended steps for mediating conflict regarding potentially inappropriate treatment...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28157752/stroke-rehabilitation
#6
Samir R Belagaje
PURPOSE OF REVIEW: Rehabilitation is an important aspect of the continuum of care in stroke. With advances in the acute treatment of stroke, more patients will survive stroke with varying degrees of disability. Research in the past decade has expanded our understanding of the mechanisms underlying stroke recovery and has led to the development of new treatment modalities. This article reviews and summarizes the key concepts related to poststroke recovery. RECENT FINDINGS: Good data now exist by which one can predict recovery, especially motor recovery, very soon after stroke onset...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28157751/inherited-and-uncommon-causes-of-stroke
#7
Jennifer Juhl Majersik
PURPOSE OF REVIEW: This article is a practical guide to identifying uncommon causes of stroke and offers guidance for evaluation and management, even when large controlled trials are lacking in these rarer forms of stroke. RECENT FINDINGS: Fabry disease causes early-onset stroke, particularly of the vertebrobasilar system; enzyme replacement therapy should be considered in affected patients. Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), often misdiagnosed as multiple sclerosis, causes migraines, early-onset lacunar strokes, and dementia...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28157750/management-of-unruptured-intracranial-aneurysms-and-cerebrovascular-malformations
#8
Kelly D Flemming, Giuseppe Lanzino
PURPOSE OF REVIEW: Unruptured intracranial aneurysms and vascular malformations are detected more frequently because of the increased use and availability of brain imaging. Management of these entities requires knowledge of which patients are at high risk for hemorrhage and what treatment options are available. This article summarizes the epidemiology, natural history, and management strategies for unruptured intracranial aneurysms, arteriovenous malformations, cavernous malformations, developmental venous anomalies, and capillary telangiectasias...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28157749/arterial-ischemic-stroke-in-children-and-young-adults
#9
Warren D Lo, Riten Kumar
PURPOSE OF REVIEW: This article reviews risk factors, recurrence risk, evaluation, management, and outcomes of arterial ischemic stroke in children and young adults. RECENT FINDINGS: The risk for recurrence and mortality appear to be low for neonatal and childhood stroke. Most children have relatively mild deficits, but those who have greater neurologic deficits, poststroke epilepsy, or strokes early in life are at risk for lower overall cognitive function. Stroke recurrence and long-term mortality after stroke in young adults are greater than originally thought...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28157748/large-artery-atherosclerotic-occlusive-disease
#10
John W Cole
PURPOSE OF REVIEW: Extracranial or intracranial large artery atherosclerosis is often identified as a potential etiologic cause for ischemic stroke and transient ischemic attack. Given the high prevalence of large artery atherosclerosis in the general population, determining whether an identified atherosclerotic lesion is truly the cause of a patient's symptomatology can be difficult. In all cases, optimally treating each patient to minimize future stroke risk is paramount. Extracranial or intracranial large artery atherosclerosis can be broadly compartmentalized into four distinct clinical scenarios based upon the individual patient's history, examination, and anatomic imaging findings: asymptomatic and symptomatic extracranial carotid stenosis, intracranial atherosclerosis, and extracranial vertebral artery atherosclerotic disease...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28157747/cardioembolic-stroke
#11
Cumara B O'Carroll, Kevin M Barrett
PURPOSE OF REVIEW: Cardioembolic stroke is common and disproportionately more disabling than nonembolic mechanisms of stroke. Its incidence is expected to rise because of the age-related incidence of atrial fibrillation and an aging population. This article summarizes the different causes of cardioembolism and outlines current management guidelines. RECENT FINDINGS: Since cardioembolic stroke is not a single disease entity, its diagnosis requires initial clinical suspicion and a comprehensive evaluation, including ECG, echocardiography, brain imaging, and cardiac monitoring...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28157746/prevention-and-management-of-poststroke-complications
#12
Josephine F Huang
PURPOSE OF REVIEW: This article provides a synopsis of the immediate and delayed medical complications of stroke, with an emphasis on prevention and management of these complications. RECENT FINDINGS: Meta-analysis of the trials for endovascular treatment of acute stroke shows no significant increase in hemorrhagic events. Rehabilitation guidelines published by the American Heart Association and American Stroke Association in 2016 aid in providing the best clinical practice for patients with stroke, from the time of their initial hospitalization to their return to the community...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28157745/diagnosis-and-management-of-transient-ischemic-attack
#13
Shelagh B Coutts
PURPOSE OF REVIEW: This article reviews the diagnosis, investigation, and recommended management after a transient ischemic attack (TIA) and discusses how to make an accurate diagnosis, including the diagnosis of mimics of TIAs. RECENT FINDINGS: Up to a 10% risk of recurrent stroke exists after a TIA, and up to 80% of this risk is preventable with urgent assessment and treatment. Imaging of the brain and intracranial and extracranial blood vessels using CT, CT angiography, carotid Doppler ultrasound, and MRI is an important part of the diagnostic assessment...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28157744/treatment-of-acute-ischemic-stroke
#14
Alejandro A Rabinstein
PURPOSE OF REVIEW: This article provides an update on the state of the art of the emergency treatment of acute ischemic stroke with particular emphasis on the alternatives for reperfusion therapy. RECENT FINDINGS: The results of several randomized controlled trials consistently and conclusively demonstrating that previously functional patients with disabling strokes from a proximal intracranial artery occlusion benefit from prompt recanalization with mechanical thrombectomy using a retrievable stent have changed the landscape of acute stroke therapy...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28157743/clinical-evaluation-of-the-patient-with-acute-stroke
#15
Andrew M Southerland
PURPOSE OF REVIEW: This article reviews the clinical evaluation of the patient with acute stroke, including key questions in the focused stroke history, important aspects of the National Institutes of Health Stroke Scale and focused neurologic examination, and the significance of the basic head CT scan in informing a timely treatment decision. RECENT FINDINGS: Advances in both stroke treatment and enhanced diagnostics support an evolving paradigm for acute stroke care, ranging from the prehospital setting to the rehabilitative setting...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28157742/stroke-epidemiology-and-risk-factor-management
#16
Amy Guzik, Cheryl Bushnell
PURPOSE OF REVIEW: Death from stroke has decreased over the past decade, with stroke now the fifth leading cause of death in the United States. In addition, the incidence of new and recurrent stroke is declining, likely because of the increased use of specific prevention medications, such as statins and antihypertensives. Despite these positive trends in incidence and mortality, many strokes remain preventable. The major modifiable risk factors are hypertension, diabetes mellitus, tobacco smoking, and hyperlipidemia, as well as lifestyle factors, such as obesity, poor diet/nutrition, and physical inactivity...
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28157741/avoiding-infractions-in-the-management-of-infarctions
#17
(no author information available yet)
No abstract text is available yet for this article.
February 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/27922875/list-of-abbreviations
#18
(no author information available yet)
No abstract text is available yet for this article.
December 2016: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/27922874/key-points-for-issue
#19
(no author information available yet)
No abstract text is available yet for this article.
December 2016: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/27922873/issue-overview
#20
(no author information available yet)
No abstract text is available yet for this article.
December 2016: Continuum: Lifelong Learning in Neurology
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