Evaluation. Detection. Diagnosis. Management.
In Emergency, Outpatient, and Inpatient Settings
Neurological Emergencies will be held online this year, using live streaming, electronic Q&A, and other remote learning technologies.
OVERVIEW
This special program provides new strategies, updates, best practices, and practical tips for:
• The WORKUP of common neurological complaints and high-risk conditions
• RAPID DETECTION of a neurological emergency and EARLY ACTIONS to optimize patient outcomes in emergency department, outpatient, and inpatient settings
• STATE-OF-THE-ART DIAGNOSIS and MANAGEMENT of HIGH-RISK NEUROLOGICAL CONDITIONS:
o Ischemic Stroke
o TIA
o Carotid stenosis
o Intracerebral hemorrhage
o Traumatic brain injury
o Cerebral aneurysm
o Spinal cord compression
o Cauda equina syndrome
o RCVS
o Cerebral venous sinus thrombosis
o Seizures
o Coma
2024 COURSE HIGHLIGHTS
EVALUATION, DETECTION, EARLY ACTION
• Best practices for the workup of common neurological complaints: Headache, Back Pain, Dizziness, Weakness, and Altered Mental Status
• Optimized approaches to the history and the physical exam
• An algorithmic approach to evaluating headaches (what tests to do and when to image)
• A practical algorithmic approach to back pain; how to spot the history and examination “red flags,” when to image, and what to look for
• Acute weakness"the evidence-based initial evaluation
• The modern evidence-based evaluation of dizziness: spoiler alert"physical exam beats imaging!
• Video clips from actual patients that help you see, “firsthand,” hard-to-describe physical exam findings
• How to do a “meaningful neurologic exam” on a patient when numerous other patients are waiting to be seen: what to do and how to prioritize
• The best workup for subarachnoid hemorrhage; is the lumbar puncture dead, or just wounded?
• The best inpatient workup for stroke, including how to treat it and what testing needs to be done urgently
• Best current evaluation of altered mental status and coma
• How to determine when a coma patient is not recoverable or brain dead
• The right workup for patients with syncope; who needs to be admitted?
• Reversible cerebral vasoconstriction syndrome (RCVS): what it is and what to look for
• Early actions for patients with severe TBI
DIAGNOSIS
• Optimize the physical exam: diagnosing dizziness at the bedside
• Diagnosis of headaches:
o Optimized use of CT/CTA/CTP, including what to order and how to interpret results
o Optimized use of MRI, including what to order, when to order, and when NOT to order
o How do I know which headache patients need neuroimaging, and which test should I order? Which blood tests can help and when to order them?
• The right tests to order for potential stroke: when to order CTA, CTP, MRI, MRA, and what is the difference between them?
• How to tell if it is a stroke mimic
• Functional neurologic disorders"how to distinguish, how to manage, and how to most effectively communicate to patients
• Back pain: when to order imaging, what to order, and how to interpret results
• When and how to use point-of-care ultrasound to diagnose or treat neurologic complaints
MANAGEMENT of HIGH-RISK NEUROLOGICAL CONDITIONS
• Updates for acute management of spinal cord and cauda equina compression
• Advances in subdural hematoma management
• Advances in the management of seizures
• State-of-the-art management of cerebral aneuryms and SAH
• Updates in ED and ICU management of TBI
• Management of head injuries
• Management of complex headaches
• Management of coma and delirium
• Updates in anticoagulation reversal for ICH and TBI
• Endovascular stroke treatment: updates, criteria to determine which patients are candidates for it, when to call the interventionalist
• What to do with patients who might have had a TIA (and when to do it)
• Thrombolytics in stroke: updates and criteria to determine who should (and should not) receive this treatment
• What to do when you find a cerebral aneurysm: determining which patients get surgery and who needs follow-up
• Evidence of cauda equina or spinal cord injury: what to do; information needed by spine surgeons; when to call them and criteria to determine who needs surgery
• Updates for intracerebral hemorrhage patients and whether they need blood pressure treatment, anticoagulation reversal, or neurosurgery.
• Acute seizures: treatment updates; how to tell if they are nonepileptic seizures; how to manage them in the inpatient (and outpatient) setting; how to choose among all the antiepileptic drugs
• Treating patients with a carotid or vertebral artery dissection
• Patients with minor head injury and concussion: what they need acutely, and what they need in follow-up
• What to do with the patient who has dizziness
• What to do with patients if you think they have a functional neurologic disorder
• What to do when a patient’s underlying neurologic disorder seems to be getting acutely worse
• What to do when you find a new brain mass on neuroimaging
STATE-OF-THE-ART STROKE MANAGEMENT
• Modern stroke management: optimizing IV thrombolytics and endovascular therapy using advanced imaging rather than just the clock
• New criteria to identify stroke patients for endovascular therapy
• The newest approaches to treat TIA and ICH
• Updates in anticoagulation reversal for ICH and TBI
• Treating stroke up to 24 hours after onset
• Treating TIA and intracerebral hemorrhage
• Updates in ischemic stroke, arterial dissections, and reversible cerebral vasoconstriction syndrome
• The right tests to order for potential stroke: when to order CTA, CTP, MRI, MRA, and what is the difference between them?
• Determining if it is a stroke or stroke mimic
• How to avoid missing posterior circulation strokes
CARE OF ELDERLY PATIENTS
• How to ensure the best care for elderly patients who have fallen
• Elderly patients with syncope, delirium, or altered mental status: special considerations for care
• How to determine which patients need further workup for a cause of a fall and which need testing for acute injuries
• Gait disturbance in the elderly
RISK MITIGATION
• Avoiding misdiagnosis
• Mitigating liability
• Medical errors: how to avoid them
• Guidance to address medical errors when they happen
UNIQUE TO THIS PROGRAM
Every year there is a vast amount of practice-changing literature on diagnosis and treatment for patients with neurological emergencies. This program provides important updates including current approaches to the history, the physical, and early management.
As a new or returning participant, you can rely on this program to ensure you are up to date with the latest information and prepared to:
• Better evaluate high-frequency neurological symptoms and high-risk neurological conditions
• Avoid misdiagnosis
• Quickly identify a neurological emergency and act in the first hours to optimize patient outcomes in the emergency, inpatient, and outpatient settings
• Optimize your use of diagnostics
• Incorporate updates in practice to ensure state-of-the-art management of high-risk neurological conditions
• Presents video clips from actual patients that help participants see, “firsthand,” hard-to-describe physical exam findings
The faculty is assembled from the best clinician-educators at Harvard Medical School, Massachusetts General Hospital (MGH), Beth Israel Deaconess Medical Center (BIDMC), and other leading medical centers.
The program is designed to deliver the highest-quality educational experience:
• Teaching practical, effective clinical reasoning and approaches that enable you to deliver state-of-the-art care
• Allowing time for participants to interact with faculty and to pose and get answers to your specific questions
• Providing the latest information in an engaging manner and clinically usable context so that you have knowledge that you can “take home” and immediately apply to patient care
OPTIMIZED FOR REMOTE EDUCATION
The 2024 program has been enhanced for distance learning. In addition to being live streamed, all sessions will be recorded and made available to participants for online viewing for 60 days after the end of the course.
