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E-grāmata: Neurologic Complications of Cancer

(Evelyn Frew American Cancer Society Clinical Research Professor, Memorial Sloan-Kettering Cancer Center, USA), (Chair, Department of Neurology, Memorial Sloan-Kettering Cancer Center, USA)
  • Formāts: PDF+DRM
  • Sērija : Contemporary Neurology Series
  • Izdošanas datums: 10-Oct-2008
  • Izdevniecība: Oxford University Press Inc
  • Valoda: eng
  • ISBN-13: 9780199710553
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    • Oxford Medicine Online e-books
  • Formāts: PDF+DRM
  • Sērija : Contemporary Neurology Series
  • Izdošanas datums: 10-Oct-2008
  • Izdevniecība: Oxford University Press Inc
  • Valoda: eng
  • ISBN-13: 9780199710553
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Patients with cancer can suffer from a bewildering variety of neurologic signs and symptoms. The neurologic symptoms are often more disabling than the primary cancer. Symptoms including confusion, seizures, pain and paralysis may be a result of either metastases to the nervous system or one of several nonmetastatic complications of cancer. The physician who promptly recognizes neurologic symptoms occurring in a patient with cancer and makes an early diagnosis may prevent the symptoms from becoming permanently disabling or sometimes lethal. This monograph, an update of the first edition published in 1995, is divided into 3 sections. The first classifies the wide variety of disorders that can cause neurologic symptoms the patient with cancer, discusses the pathophysiology of nervous system metastases, the pathophysiology and treatment of brain edema and the approach to supportive care of common neurologic symptoms such as seizures, pain, and side effects of commonly used supportive care agents. The second section is devoted to nervous system metastases, addressing in turn, brain, spinal cord, meningeal and cranial and peripheral nerve metastases, describing clinical symptoms, approach to diagnosis and current treatment. The third section addresses several nonmetastatic complications of cancer and includes sections on vascular disease, infections, metabolic and nutritional disorders, side chemotherapy, radiation and other diagnostic and therapeutic procedures. The final chapter addresses paraneoplastic syndromes.

The book is intended for practicing oncologists, neurologists, neurosurgeons and radiation oncologists as well as internists who treated patients with cancer. Our attempt was to write a book that would assist oncologists in understanding neurologic problems and neurologists in understanding oncologic problems. The book is also intended for physicians training to specialize in any of the above areas. It includes a practical approach to the diagnosis and management of patients with neurologic disease who are with known to have cancer or in whom cancer is suspected.

Recenzijas

I would judge that this work may justly be described as a tour de force, a marvellous synthesis. * AJ Larner, Walton Centre for Neurology and Neurosurgery * There is very little in this book [ that] does not affect the practice of the neurointensivist. Now thoroughly updated and modernized, this is an enormously worthwhile book. EFM Wijdicks MD, PhD

Part
1. General Principles
Overview
3(28)
Introduction
3(1)
Rationale For Neuro-Oncology
4(12)
Nervous System Complications of Cancer Are Common
4(4)
Neurologic Complications of Cancer Are Increasing
8(2)
Neurologic Complications of Systemic Cancer Are Serious
10(1)
Diagnosis Is Often Difficult
10(1)
Treatment Helps
11(2)
Problems in Neuro-Oncology Are Unique
13(2)
Research Is Essential
15(1)
Relationships between the Brain and Systemic Cancer Are Biologically Important
15(1)
Classification of Neuro-Oncologic Disorders
16(3)
Spread of Cancer to the Nervous System (Metastatic or Direct Effects of Cancer)
17(1)
Indirect Neurologic (Nonmetastatic or Paraneoplastic) Complications of Cancer
18(1)
Approach to the Patient
19(4)
Known Cancer
20(2)
No Known Cancer
22(1)
Evaluating the Patient
23(5)
References
28(3)
Pathophysiology of Nervous System Metastases
31(33)
Introduction
31(1)
Pathophysiology of the Metastatic Process
32(12)
Transformation and Growth
32(3)
Vascularization (Angiogenesis)
35(1)
Invasion
36(1)
Intravasation
36(1)
Circulation
37(2)
Arrest: First Capillary Bed
39(1)
Passage to Arterial Circulation
39(1)
Arrest: Final Capillary Bed
40(1)
Tumor Emboli
41(1)
Extravasation
41(1)
Dormancy
41(2)
Growth in the CNS
43(1)
Clinical Considerations Relevant to Nervous System Metastasis
44(5)
Tumor Size and Lymph Node Involvement
44(1)
Properties of Metastases
45(1)
Differences between a Primary Tumor and Its Metastases
45(1)
Site of Metastases
45(4)
Pathophysiologic Factors Relevant to Spread And Growth of Cancer to Specific Neural Structures
49(8)
Brain
49(1)
Spinal Cord
50(2)
Leptomeninges
52(3)
Cranial and Peripheral Nerves
55(2)
References
57(7)
Blood-Nervous System Barrier Dysfunction: Pathophysiology and Treatment
64(31)
Introduction
64(3)
Anatomy and Physiology
67(5)
Blood-Brain Barrier
68(3)
Blood-Peripheral Nerve Barrier
71(1)
Blood-Cerebrospinal Fluid Barrier
71(1)
Disruption of Blood-Central Nervous System Barriers
72(6)
Brain Edema
73(2)
Other Sources of Disruption
75(1)
Other Substances Causing Blood-Brain Barrier Disruption
76(2)
Consequences of Blood-Brain Barrier Disruption: Increased Intracranial Pressure, Plateau Waves, and Cerebral Herniation
78(4)
Treatment of Cerebral Herniation
81(1)
Transport of Chemotherapeutic Drugs Across the Blood-Brain Barrier
82(2)
Restoration of Blood-Central Nervous System Barriers
84(5)
Lowering Intracranial Pressure
84(1)
Corticosteroids
84(5)
References
89(6)
Supportive Care and Its Complications
95(46)
Introduction
95(3)
Edema/Corticosteroids
98(9)
Salutary Effects of Corticosteroids
99(1)
Unwanted Effects of Corticosteroids
100(7)
Seizures/Anticonvulsants
107(10)
Incidence/Epidemiology
107(2)
Therapy
109(5)
Untoward Effects of Anticonvulsants
114(3)
Venous Thrombosis/Anticoagulants
117(3)
Pain/Analgesia
120(3)
Psychological Distress/Psychotropic Agents
123(1)
Fatigue
124(1)
Nausea, Vomiting/Antiemetic Agents
125(1)
Infection/Antibiotics
125(5)
Intensive Care/Common Agents
130(1)
References
130(11)
Part
2. Metastases
Intracranial Metastases
141(53)
General Principles
141(5)
Introduction
141(1)
Classification
142(2)
Incidence
144(2)
Brain Metastases (Parenchymal)
146(27)
Source
146(2)
Pathophysiology of Neurologic Symptoms and Signs
148(2)
Pathology
150(1)
Clinical Findings
150(5)
Laboratory Findings
155(3)
Differential Diagnosis
158(2)
Approach to the Patient without Known Cancer
160(1)
Treatment
160(12)
Prognosis
172(1)
Specific Tumors
173(5)
Small Cell Lung Cancer
173(1)
Non-Small Cell Lung Cancer
173(1)
Breast
174(1)
Melanoma
175(1)
Renal
176(1)
Colon
176(1)
Testis
176(1)
Gynecologic Tumors
177(1)
Sarcomas
177(1)
Hematologic Cancers
177(1)
Unknown Primary
178(1)
Less Common Sites of Intracranial Metastases
178(4)
Calvarial Metastases
178(1)
Dural Metastases
178(2)
Pineal
180(1)
Choroid
181(1)
Pituitary
181(1)
References
182(12)
Spinal Metastases
194(46)
Introduction
194(3)
Epidural Metastases
197(33)
Frequency
197(2)
Biology of Epidural Metastases
199(1)
Pathophysiology of Symptoms and Signs
200(2)
Pathology
202(1)
Clinical Findings
203(6)
Laboratory Examination
209(4)
Differential Diagnosis
213(2)
Treatment
215(12)
Decision-Making in Epidural Spinal Cord Compression
227(1)
Specific Tumors
227(3)
Intradural and Intramedullary Metastases
230(3)
Diagnosis
231(1)
Treatment
232(1)
References
233(7)
Leptomeningeal Metastases
240(42)
Introduction
240(2)
Frequency
242(3)
Pathophysiology of Signs and Symptoms
245(3)
Hydrocephalus
245(1)
Parenchymal Invasion
246(1)
Ischemia
246(1)
Metabolic Competition
246(1)
Immune Responses
246(2)
Inflammation
248(1)
Blood-Cerebrospinal Fluid Barrier Disruption
248(1)
Clinical Findings
248(3)
Cerebral (Brain) Symptoms and Signs
249(1)
Cranial Nerve Symptoms and Signs
250(1)
Spinal Symptoms and Signs
251(1)
Laboratory Tests
251(11)
Magnetic Resonance Imaging
251(4)
Lumbar Puncture
255(6)
Other Diagnostic Tests
261(1)
Differetial Diagnosis
262(2)
Diagnostic Approach
263(1)
Treatment
264(6)
Radiation Therapy
265(1)
Chemotherapy
266(3)
Surgery
269(1)
Prognosis
270(4)
References
274(8)
Cancer Involving Cranial And Peripheral Nerves and Muscles
282(43)
Introduction
282(1)
Frequency
282(1)
Cranial Nerves
283(17)
Clinical Findings
285(15)
Diagnosis and Treatment
300(1)
Spinal Roots
300(1)
Nerve Plexuses
301(11)
Cervical Plexus
302(1)
Brachial Plexus
302(5)
Lumbosacral Plexus
307(5)
Peripheral Nerves
312(2)
Monoeuropathies
312(2)
Polyneuropathy
314(1)
Muscles
314(2)
References
316(9)
Part
3. Nonmetastatic Complications of Cancer
Vascular Disorders
325(44)
Introduction
325(1)
Frequency
326(1)
Pathophysiology of Cerebrovascular Disease
327(3)
Hypocoagulation
327(1)
Hypercoagulation
328(2)
Central Nervous System Hemorrhage
330(10)
Hemorrhage into Brain Metastases
330(4)
Subdural Hemorrhage
334(1)
Coagulopathic Hemorrhage
335(3)
Leukostasis
338(1)
Hyperviscosity
339(1)
Hypertension
339(1)
Central Nervous System Infarction
340(17)
Atherosclerosis
340(1)
Disseminated Intravascular Coagulation
341(5)
Arterial Occlusion by Extrinsic Tumor
346(1)
Cerebral Emboli
346(8)
Thrombotic Microangiopathy
354(1)
Cerebral Vasculitis
355(1)
Intravascular Lymphoma
356(1)
Thrombocytosis
356(1)
Venous Occlusions
357(3)
Compressive Venous Sinus Occlusion
357(1)
Venous Sinus Thrombosis
358(2)
Tumor Emboli
360(1)
Other Disorders
360(2)
Systemic Thrombophlebitis
360(1)
Episodic Neurologic Dysfunction in Patients with Hodgkin Disease
360(1)
Systemic Hypotension
360(2)
Air Embolism
362(1)
Approach to the Patient
362(1)
References
362(7)
Central Nervous System Infections
369(49)
Introduction
369(2)
Pathophysiology of Central Nervous System Infection
371(6)
Host Defenses
371(3)
Infection Sites within the Central Nervous System
374(3)
Clinical Findings
377(9)
Signs and Symptoms
377(1)
Meningitis
377(7)
Meningoencephalitis
384(1)
Brain Abscess
385(1)
Vascular Lesions
386(1)
Approach to the Patient
386(2)
Specific Organisms Causing Central Nervous System Infection in Patients with Cancer
388(21)
T-Lymphocyte and Mononuclear Phagocyte Defects
388(13)
Neutrophil Defects
401(5)
Splenectomy or B-Cell Abnormalities
406(1)
Cerebrospinal Fluid-Surface Communication
407(1)
Other Infections
408(1)
References
409(9)
Delirium and Metabolic and Nutritional Complications of Cancer
418(29)
Introduction
418(1)
Delirium Associated with Cancer
419(5)
Definition
419(1)
Incidence
420(1)
Pathophysiology
420(1)
Clinical Findings
420(1)
Diagnosis
421(2)
Causes of Delirium
423(1)
Metabolic Brain Disease in Patients with Cancer
424(3)
Incidence
425(1)
Clinical Signs
425(1)
Laboratory Tests
425(1)
Differential Diagnosis
426(1)
Treatment
426(1)
Specific Metabolic Causes of Delirium
427(10)
Postoperative Delirium
427(1)
Drugs
427(2)
Substrate Deprivation (Hypoxia-Ischemia-Hypoglycemia)
429(2)
Hyperglycemia
431(1)
Sepsis
431(2)
Electrolyte Imbalance
433(3)
Endocrine and Other Organ Dysfunctions
436(1)
Organ Failure
437(1)
Tumor Lysis Syndrome
437(1)
Lactic Acidosis
437(1)
Nutritional Disorders Associated with Cancer
437(5)
Malnutrition and Cachexia
438(1)
Disorders of Nutrient Deprivation Associated with Cancer
439(3)
References
442(5)
Side Effects of Chemotherapy
447(64)
Introduction
447(1)
Clinical Findings and Diagnosis
448(5)
Peripheral Nervous System
450(1)
Central Nervous System
451(1)
Non-Neurologic Toxicity
452(1)
Specific Agents
453(34)
Cytotoxic Agents
453(25)
Antineoplastic Hormones
478(1)
Biologic Agents
479(6)
Differentiation Agents
485(1)
Hematopoietic Stem Cell Transplantation (HSCT)
486(1)
Adjuvant Agents
486(1)
References
487(24)
Side Effects of Radiation Therapy
511(45)
Introduction
511(1)
Biology of Radiation Damage
511(4)
Ionization
511(1)
Fractionation
512(1)
Mechanisms of Nervous System Damage
512(1)
The Linear-Quadratic Concept
513(2)
Diagnosis of Radiation-Induced Neurotoxicity
515(27)
Direct Radiation Damage to the Nervous System
515(22)
Indirect Nervous System Damage
537(5)
treatment
542(2)
References
544(12)
Neurotoxicity of Surgical and Diagnostic Procedures
556(21)
Introduction
556(1)
Disorders Resulting from Anesthesia
556(4)
General Anesthesia
556(3)
Regional Anesthesia
559(1)
Intubation
559(1)
Surgery
560(8)
Craniotomy
560(3)
Base of Skull Surgery
563(1)
Spinal Surgery
564(1)
Head and Neck Surgery
564(2)
Breast Surgery
566(1)
Thoracotomy
567(1)
Abdominal/Pelvic Surgery
567(1)
Extremity Surgery
568(1)
Diagnostic Procedures Causing Neurotoxicity
568(5)
Computed Tomography
568(1)
Lumbar Puncture
568(4)
Arterial/Venous Catheters
572(1)
Epidural/Intrathecal Catheters
573(1)
References
573(4)
Paraneoplastic Syndromes
577(42)
Introduction
577(1)
General Considerations
578(7)
Classification
578(1)
Frequency
579(1)
Importance
580(1)
Pathogenesis
581(2)
Diagnosis
583(1)
Prognosis
584(1)
Treatment
585(1)
Specific Syndromes
585(24)
Paraneoplastic Cerebellar Degeneration
585(8)
Subacute Sensory Neuronopathy/Encephalomyelitis
593(4)
Opsoclonus/Myoclonus (OM)
597(1)
Spinal Cord Syndromes
598(2)
Cranial Nerves
600(1)
Peripheral Nerve Syndromes
601(3)
Neuromuscular Junction
604(4)
Muscle
608(1)
References
609(10)
Index 619