bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tumors of the Pituitary Gland
Authors: Fong Reginald , Conger Andrew R. 
Published: June 2023

Abstract
Tumors of the pituitary gland account for approximately 10–15% of intracranial neoplasms, with an incidence ranging from 1 to 20 cases per 100,000 per year. Pituitary tumors represent a wide range of pathologies. The 2017 World Health Organization Classification of Tumors of Endocrine Organs lists 19 different pathologies originating from cell lines intrinsic to the pituitary gland. They require an understanding of endocrinology, genetics, and surgical options in order to manage them effectively. The majority of pituitary tumors are non-functional tumors; however, that does not preclude them from affecting the hypothalamic-pituitary axis due to mass effect. A full endocrine history and workup are required as a first step when a pituitary lesion is diagnosed. From there the management largely depends on the patient’s visual exam, physical exam, medical history, and comorbidities. Treatment options range from medical management, radiation therapy, and surgical resection, to chemotherapy. The majority of pituitary tumors are best managed by a multidisciplinary team that includes the combination of a neuro-endocrinologist, neurosurgeon, neuro-oncologist, and radiation oncologist. Craniopharyngiomas represent a unique pituitary lesion that are histologically and cytologically benign but can be locally aggressive and require surgical resection for cure. They are unique in the sense that some subtype expresses a gene that may prove to be a viable target for chemotherapy.
Primary Central Nervous System Lymphoma and Hematopoietic Neoplasms Affecting the Nervous System
Authors: Lim-Fat Mary Jane , Nayak Lakshmi 
Published: June 2023

Abstract
Primary central nervous system lymphoma (PCNSL) is a rare and aggressive variant of extranodal non-Hodgkin lymphoma involving compartments of the central nervous system, including the brain, leptomeninges, eyes, or spinal cord without evidence of systemic disease. PCNSL poses unique challenges to the neuro-oncologist in terms of clinical presentation, extent of disease evaluation, and treatment strategies. This chapter details the epidemiology, pathophysiology, differential diagnosis, investigations, management, and prognosis of PCNSL, with a focus on the most salient points for the neuro-oncologist. CNS involvement from other hematological malignancies will also be briefly discussed.
Tumors Affecting the Spinal Cord
Authors: Verla Terrence , Curley Kara L. , Neal Matthew T. , Ropper Alexander 
Published: June 2023

Abstract
This chapter provides an overview of intramedullary, intradural extramedullary, and extradural spinal tumors. The chapter reviews the epidemiology, pathophysiology, clinical manifestations, imaging, and management for each category of tumor. The most common types of intramedullary tumors are ependymoma, astrocytoma, and hemangioblastoma. The most common types of intradural, extramedullary tumors are meningioma, schwannoma, and neurofibroma. Extradural tumors are most commonly metastatic in nature. Primary bone tumors have diverse pathologies and make up the minority of extradural tumors.
Pediatric Low-Grade Glioma
Authors: Phadnis Sheetal , Nicolaides Theodore 
Published: June 2023

Abstract
Pediatric low-grade gliomas (PLGGs) are the most common subgroup of central nervous system (CNS) tumors in childhood. These tumors have a good prognosis, especially when they are completely resectable. Traditional cytotoxic chemotherapy and radiation therapy have proved to be effective in many unresectable cases, but careful attention to age of the patient and location of the tumor must be considered before embarking on a treatment plan. More recently, targeted therapy with either BRAF or MEK inhibitors has shown promising efficacy, and these agents are likely to play an increasing role in treatment of these patients moving forward.
Radiotherapy in Neuro-Oncology
Authors: Blau Molly Havard , Halasz Lia M. 
Published: June 2023

Abstract
This chapter provides an overview of radiation therapy specific to the central nervous system (CNS). The roles of each member of the planning and treatment teams are described, followed by a brief explanation of the radiobiologic effects of therapeutic radiation. The treatment modalities most commonly used for CNS tumors are described (e.g., photon, proton, and stereotactic radiation), highlighting common delivery systems. The chapter discusses treatment paradigms for specific diagnoses including high-grade gliomas (HGG), low-grade gliomas (LGG), brain metastases, benign brain tumors (meningioma, vestibular schwannoma, craniopharyngioma), and pediatric malignancies (medulloblastoma, ependymoma, diffuse pontine glioma). Radiation toxicity is discussed in the context of each diagnosis and treatment modality, as well as mitigation techniques to minimize the risk of radiation induced side effects.
Paraneoplastic Neurological Syndromes
Authors: Valencia-Sanchez Cristina , Mrugala Maciej M. 
Published: June 2023

Abstract
Paraneoplastic neurological syndromes (PNS) are immune-mediated disorders that occur as a result of autoimmune responses triggered by the ectopic expression of neuronal proteins in cancer cells. Patients typically present with subacute multifocal symptoms involving any area of the central and/or peripheral nervous systems. The neurologic disorder usually appears before the cancer has been identified. Recognition of the syndromes and antibody testing in serum and cerebrospinal fluid are essential for an early diagnosis and detection of an underlying malignancy. Each of these antibodies is predominantly associated with a different type of tumor, so the antibody detected is useful to guide diagnostic tests used to search for an underlying tumor. Treatment of these syndromes includes immunosuppressive therapies in conjunction with treatment of the tumor. The recent introduction of immune-checkpoint inhibitors into cancer treatment has revealed an increased incidence of neurological immune-related adverse effects that can manifest as PNS.
Neuro-Oncologic Emergencies
Authors: Hrachova Maya , Gritsch David , Gritsch Simon , Mrugala Maciej M. 
Published: June 2023

Abstract
Neuro-oncologic emergencies commonly arise in patients with brain tumors and systemic malignances, prompting expedited evaluation and management. Neurological complications are multifactorial in nature and stem from either direct tumor invasion or from underlying systemic processes. Status epilepticus, stroke, and metastatic spinal cord compression are the most common causes of morbidity due to the direct tumor effect. Inversely, adverse effects of chemotherapy (CAR-T), coagulopathy, pulmonary embolism, thrombocytopenia, and neutropenia are attributed to systemic involvement. Thus, it is essential to recognize signs and symptoms of neurological urgency in a timely manner to prevent serious and irreversible complications. This chapter reviews common neuro-oncological emergencies and provides a framework for their diagnostic workup and management.
Familial Syndromes in Neuro-Oncology
Authors: Dhamija Radhika , Hoxworth Joseph M. , Asthagiri Ashok R. 
Published: June 2023

Abstract
Familial cancer syndromes are caused by inherited mutations in tumor suppressor genes and are most commonly autosomal dominant in inheritance. Many of these syndromes increase the risk for central nervous system tumors. Early identification of these tumor syndromes is important to patient outcomes, and advances in genetic testing has made that possible. Common familial cancer syndromes associated with central nervous system tumors are neurofibromatosis types 1 and 2, Cowden syndrome, tuberous sclerosis complex, Li-Fraumeni syndrome, Turcot syndrome, Gorlin syndrome, and Von Hippel Lindau syndrome. This chapter discusses in detail the cardinal features of these syndromes with emphasis on neurological manifestations.
Neurologic Manifestations of Muscle Relaxants and Drugs Used for Analgesia and Anesthesia in the Intensive Care Unit
Authors: Wijdicks Eelco F.M. 
Published: June 2023

Abstract
Sedation aside, many analgesic drugs are used in the ICU, predominantly in surgical ICUs. Neuromuscular-blocking agents are used frequently for brief procedures but can be administered for prolonged periods of time. Consulting neurologists often find that the combined use of opioids and benzodiazepines confounds the examination. Moreover, the duration of infusion of analogosedative drug combinations affect clearance, drugs do not clear well in critical illness, and drug-drug interactions are often underestimated. It is necessary to think through the absorption, distribution, and the two routes of drug elimination (metabolism and excretion) in patients and assess accurately the effect of drug interactions, body physique, or age. This chapter provides a full scope of drugs that may confound neurologic examination.
Seizures in the Intensive Care Unit
Authors: Wijdicks Eelco F.M. 
Published: June 2023

Abstract
Seizures in critically ill patients are a common reason for neurologic consultation. The causes and management of seizures are discussed in relation to this unique situation. Seizures may be more consequential in critical illness because they may impact on already unstable vital signs. Causes of seizures are discussed, including drug-induced seizure and seizures brought about by the withdrawal of certain drugs. Status epilepticus is major neuroemergency, and clinicians have an obligation to press on quickly with treatment, to correct metabolic abnormalities, and assess for structural abnormalities and lesions in the central nervous system. This chapter discusses how to manage recurrent seizures and the evolution to status epilepticus, including a transition to refractory status epilepticus.
Neurologic Complications of Invasive Procedures in the Intensive Care Unit
Authors: Wijdicks Eelco F.M. 
Published: June 2023

Abstract
Critically ill patients require support systems to maintain adequate circulation and oxygenation. Some need full life support to take over. Important procedures that are commonplace in surgical and medical intensive care units can be a cause of an unintended iatrogenic neurologic complications. The type of complications associated with invasive procedures can be categorized as either reaction to injected material (air or contrast medium) or mobilization of intravascular debris. Neurologic complications pertaining to invasive procedures and assisting devices are ischemic strokes and isolated peripheral nerve damage. This chapter concentrates on complications of invasive procedures and life support systems such as extracorporeal membrane oxygenation and left ventricular assist devices.
Neurologic Manifestations of Acute Bacterial Infections and Sepsis
Authors: Wijdicks Eelco F.M. 
Published: June 2023

Abstract
Patients with community-acquired bacterial infections comprise a considerable proportion of intensive care unit admissions. Within this cohort of admission are those patients with fever, agitation, and neurologic signs suggesting a primary neurologic infection. This chapter focuses on selected disorders associated with bacterial infection, chosen largely because they are potential reasons for neurologic consultation, and many intensive care specialists seek early help with the management of bacterial meningitis, epidural abscess, complications of endocarditis, and, occasionally, clostridial syndromes. Treatment of sepsis is common in any ICU, and patients can be seriously affected. The controversies of septic encephalopathy diagnosis are also discussed.
Neurologic Complications of Cardiac Arrest
Authors: Wijdicks Eelco F.M. 
Published: June 2023

Abstract
Cardiac arrest often leads to coma post-resuscitation, and this state may be devastating and result in persistent coma or severe disability. The distribution of causes of coma changes when patients are seen in the hospital or intensive care units, when structural causes of brain injury are then more frequent. Neurologic examination can determine the cause and severity of coma, but there might also be clues from a general physical examination that may point toward a certain cause. Treatable coma, however, can be due to mass effect and its remote effect or edema that may displace the brainstem; these comas can be reversed by neurosurgical intervention. This chapter discusses the evaluation of coma, how to interpret neurologic findings, how to grade coma, and which treatment actions to consider.
Neurologic Manifestations of Acid–Base Derangements, Electrolyte Disorders, and Endocrine Crises
Authors: Wijdicks Eelco F.M. 
Published: June 2023

Abstract
Critically ill patients display a gamut of homeostatic imbalances, and it is difficult to predict the ultimate clinical response in any given patient with any degree of acute metabolic abnormality. The clinical spectrum associated with acute metabolic or endocrine derangements ranges from transient and subtle neurologic manifestations to long-lasting damage to the central nervous system. Interpretation of laboratory derangements is important because several electrolyte and acid–base abnormalities are encountered regularly in the intensive care unit. In this chapter, the most representative clinical neurologic manifestations are selected to guide clinicians in their differential diagnosis and clarify the extent of the derangement on the nervous system.
Neurologic Complications Associated with Disorders of Thrombosis and Hemostasis
Authors: Wijdicks Eelco F.M. 
Published: June 2023

Abstract
Disorders of hemostasis may be part of organ dysfunction in patients presenting to the intensive care unit (ICU), or patients may be admitted with a primary hematologic disorder causing hemorrhage or thrombus. For these patients, the primary objective is to control a life-threatening hemorrhage and immediate hemostasis, but this may not be without neurologic consequences.
This chapter reviews the major disorders of thrombosis or hemostasis most commonly encountered in ICUs and their neurologic manifestations. These manifestations may affect both the central and peripheral nervous systems. The disorders that most often generate a neurologic consult are intravascular coagulation with intracranial hemorrhage, complications of thrombolysis, and thrombotic thrombocytopenic purpura. Assessment, management, and therapeutic options are discussed.
Neurologic Complications of Acute Vasculitis Syndromes
Authors: Wijdicks Eelco F.M. 
Published: June 2023

Abstract
Several clinical entities may lead to the admittance of a patient with a necrotizing vasculitis to a medical or surgical intensive care unit. With every visceral and organ involvement comes a potentially life-threatening condition, and often they occur simultaneously. These conditions are ischemic ulceration of the gut, pulmonary hemorrhage due to small vessel vasculitis or capillaritis, necrotizing nephritis, and myocarditis. Vasculitis of cerebral vessels may produce intracranial hemorrhages or multiple-territory cerebral infarcts. The peripheral nervous system becomes involved in severe forms of acute vasculitis syndromes, with acute respiratory or renal failure. A number of vasculitis disorders are discussed, along with their management.
Neurologic Complications of Acute Environmental Injuries
Authors: Wijdicks Eelco F.M. 
Published: June 2023

Abstract
Certain types of environmental injuries can produce specific neurologic manifestations. Although these injuries have a propensity for pulmonary, cardiovascular, and renal involvement, morbidity is commonly determined by an additional injury to the brain or spinal cord. Every circumstance is different, and confounding factors, such as acute drug intoxication or an unexpected acute structural CNS lesion that has led to the injury, should be excluded. Long-term data are also not available to reach a degree of certainty with prognostication. This chapter presents an overview of the most common neurologic presentations in environmental injuries severe enough to have resulted in intensive care admission.
Neurologic Complications of Drug Overdose, Poisoning, and Terrorism
Authors: Wijdicks Eelco F.M. 
Published: June 2023

Abstract
The treatment of intoxications and poisoning is common in emergency departments and the care of these patients is continued in the intensive care unit. The neurologist can be useful in an assessment of the severity of the intoxication, but also in the management of the patient, particularly when there are recurrent seizures or permanent unexplained unconsciousness. The consulting neurologist should have a good working knowledge of the pharmacodynamics of ingested drugs in large quantities and how to interpret neuroimaging, and this chapter provides that information. A section on the weaponized use of poisons in biological and chemical warfare and the necessary emergency response is also provided.
Neurologic Complications of Organ Transplantation
Authors: Wijdicks Eelco F.M. 
Published: June 2023

Abstract
Despite the scarcity of organs and the substantial cost to society, transplantation has become firmly established as a viable cure for vital organ failure. After transplantation, patients are admitted to specially equipped surgical intensive care units. Most academic institutions have meticulously organized transplantation programs with several specialties sharing the responsibility for care of the transplant recipient. Any patient with a recent solid organ or hematopoietic stem cell transplantation may develop graft-versus-host disease, multiorgan failure, and shock. In these patients’ neurologic complications are an expected outcome. These neurologic complications may be major when they involve recurrent seizures, postoperative failure to awaken, immunosuppression neurotoxicity, or acute disabling neuromuscular disease, all of which are addressed in this chapter.
The Neurologist and ICU Ethical Dilemmas
Authors: Wijdicks Eelco F.M. 
Published: June 2023

Abstract
A number ethical situations can arise in the intensive care unit in which the consulting neurologist may be closely involved. These situations usually resolve around end-of-life care, futility of further treatment, and the decision to withdraw or withhold other than palliative treatments. Neurologists are not required to continue futile treatment in any patient nor to continue or escalate treatment in the devastatingly injured neurologic patient. Similarly, clinicians are not required to discontinue aggressive management if a clear benefit can be achieved. Discordances between the wishes of family and the views of the healthcare team in the ICU are usually avoidable when there is clear, open, and frequent communication. This chapter discusses a number of major neuroethical topics.
Mental disorders in forensic psychiatry
Authors: Eastman Nigel , Adshead Gwen , Fox Simone , Latham Richard , Whyte Seán , Williams Hannah Kate 
Published: June 2023

Abstract
This chapter covers different mental disorders and their prevalence in both the general and offending populations, specific symptoms and their relationship to violence or risk of offending, comorbidities, and assessing risk. The chapter includes functional psychosis, alcohol and drug misuse, personality disorders, psychopathy, biopolar disorder, depression and other affective disorders, post-traumatic stress disorder, anxiety, dissociative and conversion disorders, and paraphilias. It goes on to autism spectrum disorders, ADHD, conduct disorders, intellectual disability, acquired brain injury, epilepsy and sleep disorders, and organic disorders. It ends with malingering and factitious disorders.
Forensic psychiatric services
Authors: Eastman Nigel , Adshead Gwen , Fox Simone , Latham Richard , Whyte Seán , Williams Hannah Kate 
Published: June 2023

Abstract
This chapter covers different aspects of psychiatric services in the forensic setting, and the relationships between them. It begins with the structure of forensic services, and goes on to secure hospital settings, and special provisions within secure settings. Gender identity issues in secure care are explained. Rehabilitation and recovery, community services, and diversion services are all outlined, as are prison psychiatric services. Service development is described, and then population needs assessment is covered.
Conflicting ethical values
Authors: Eastman Nigel , Adshead Gwen , Fox Simone , Latham Richard , Whyte Seán , Williams Hannah Kate 
Published: June 2023

Abstract
This chapter covers the issues that arise when a forensic psychiatrist encounters a situation that may result in conflicting ethical values. It covers working in multi-disciplinary teams, with other agencies, non-public bodies, and when a psychiatrist works in a non-therapeutic context. It goes on to legal and ethical issues surrounding confidentiality and disclosure, then covers ethical risk assessment and management. Finally, the philosophy and ethics of coercion are discussed.
The interface between psychiatry and law
Authors: Eastman Nigel , Adshead Gwen , Fox Simone , Latham Richard , Whyte Seán , Williams Hannah Kate 
Published: June 2023

Abstract
This chapter introduces the interface between psychiatry and the law. It begins with the objectives of both the psychiatric and legal systems, then the associated constructs and models. Different uses of information are covered, and negotiating the interface between psychiatry and the law is outlined.
The psychiatrist in court
Authors: Eastman Nigel , Adshead Gwen , Fox Simone , Latham Richard , Whyte Seán , Williams Hannah Kate 
Published: June 2023

Abstract
This chapter covers the role of the psychiatrist in court. It starts with witnesses, experts, and expert evidence, then expands on this with the principles and law around expert evidence (including specific legal rules). It then also outlines the codes of practice for expert, and then consent and confidentiality in the court.
Clinical cases
Authors: Eastman Nigel , Adshead Gwen , Fox Simone , Latham Richard , Whyte Seán 
Published: June 2023

Abstract
This chapter provides twenty-seven clinical cases and discusses how the forensic psychiatrist should approach these difference scenarios, with self-reflection questions and discussion included for each case. It begins with setting up the concept of a forensic case, and the use of behaviour without conviction with risk assessment, and risk assessment as a whole. It also includes cases on hospital-to-prison transfer, worked examples of structured risk-assessment, and location of the patient in the presence of psychosis, personality disorders, and substance misuse. It goes on to cases with brain injury, risk assessment in sexual offending, and associated transcultural issues, complex violence, cases where there are patient threats against staff, and how to manage requests for transfer to higher security. It also contains cases on the management of violent behaviour in the absence of current mental illnesses, management of self-harm, covert treatment of violence, and remission from hospital back to prison in the case of the prisoner with a life sentence. It closes with the cases relating to social and occupational therapies in forensic psychiatry, how to work with public protection arrangements, the professional relationship with the justice ministry, recall of CTOs, supporting a court diversion scheme via consultation, and how to make a professional judgement on whether prison or hospital would be a more appropriate setting for a patient.