Reviewing The IBNCC Chapter “Neuro-oncology Emergencies

Today, I review Dr. Josh Farkas‘ Internet Book of Neurocritical Care chapter, Neuro-oncology emergencies, June 2, 2022.

All that follows is excerpted from Dr. Farkas’ chapter above.

Neuro-oncologic emergencies are commonly encountered in critical care.  Rapidly evolving biological therapies for cancer offer patients exciting benefits, but have also created new sets of complications (e.g., checkpoint inhibitor-induced encephalitis).  Patients may be suffering from complications of the malignancy itself, complications of therapy, or wholly unrelated problems.

NEURO-ONCOLOGY

• Approach to nonspecific presentations
• Direct effect of tumor mass
  • Focal mass effect with edema
  • Primary CNS lymphoma (PCNSL)
  • Pituitary apoplexy
  • Spinal cord compression
  • Leptomeningeal carcinomatosis
• Vascular
  • Acute Ischemic Stroke
  • Intracerebral Hemorrhage
  • Cerebral Venous Thrombosis
• Seizure
• Paraneoplastic syndromes
• Iatrogenic
  • Radiation therapy
  • Chemotherapy
  • PRES due to chemotherapy
  • Checkpoint inhibitors:  Immune-Related Adverse Events
• Opportunistic CNS infections
• Unique to hematologic malignancies
  • Hyperviscosity syndrome
  • Leukostasis
• Nutritional/metabolic complications of advanced malignancy
  • Wernicke encephalopathy
  • Refeeding syndrome
• Podcast
• Questions & discussion
• Pitfalls