Skip to main content
Erschienen in: Current Neurology and Neuroscience Reports 10/2016

01.10.2016 | Demyelinating Disorders (DN Bourdette and M Cameron, Section Editors)

Diagnostic Criteria, Classification and Treatment Goals in Multiple Sclerosis: The Chronicles of Time and Space

verfasst von: Achilles Ntranos, Fred Lublin

Erschienen in: Current Neurology and Neuroscience Reports | Ausgabe 10/2016

Einloggen, um Zugang zu erhalten

Abstract

Multiple sclerosis (MS) is one of the most diverse human diseases. Since its first description by Charcot in the nineteenth century, the diagnostic criteria, clinical course classification, and treatment goals for MS have been constantly revised and updated to improve diagnostic accuracy, physician communication, and clinical trial design. These changes have improved the clinical outcomes and quality of life for patients with the disease. Recent technological and research breakthroughs will almost certainly further change how we diagnose, classify, and treat MS in the future. In this review, we summarize the key events in the history of MS, explain the reasoning behind the current criteria for MS diagnosis, classification, and treatment, and provide suggestions for further improvements that will keep enhancing the clinical practice of MS.
Literatur
1.
Zurück zum Zitat Aktas O, Ullrich O, Infante-Duarte C, Nitsch R, Zipp F. Neuronal damage in brain inflammation. Arch Neurol. 2007;64:185–9.CrossRefPubMed Aktas O, Ullrich O, Infante-Duarte C, Nitsch R, Zipp F. Neuronal damage in brain inflammation. Arch Neurol. 2007;64:185–9.CrossRefPubMed
2.
Zurück zum Zitat Kuhlmann T, Miron V, Cuo Q, Wegner C, Antel J, Brück W. Differentiation block of oligodendroglial progenitor cells as a cause for remyelination failure in chronic multiple sclerosis. Brain. 2008;131:1749–58.CrossRefPubMed Kuhlmann T, Miron V, Cuo Q, Wegner C, Antel J, Brück W. Differentiation block of oligodendroglial progenitor cells as a cause for remyelination failure in chronic multiple sclerosis. Brain. 2008;131:1749–58.CrossRefPubMed
3.
Zurück zum Zitat Dutta R, McDonough J, Yin X, Peterson J, Chang A, Torres T, et al. Mitochondrial dysfunction as a cause of axonal degeneration in multiple sclerosis patients. Ann Neurol. 2006;59:478–89.CrossRefPubMed Dutta R, McDonough J, Yin X, Peterson J, Chang A, Torres T, et al. Mitochondrial dysfunction as a cause of axonal degeneration in multiple sclerosis patients. Ann Neurol. 2006;59:478–89.CrossRefPubMed
4.
Zurück zum Zitat Trapp BD, Nave K-A. Multiple sclerosis: an immune or neurodegenerative disorder? Annu Rev Neurosci. 2008;31:247–69.CrossRefPubMed Trapp BD, Nave K-A. Multiple sclerosis: an immune or neurodegenerative disorder? Annu Rev Neurosci. 2008;31:247–69.CrossRefPubMed
6.
Zurück zum Zitat Derwenskus J, Lublin FD. Future treatment approaches to multiple sclerosis. Handb Clin Neurol. 2014;122:563–77.CrossRefPubMed Derwenskus J, Lublin FD. Future treatment approaches to multiple sclerosis. Handb Clin Neurol. 2014;122:563–77.CrossRefPubMed
8.
Zurück zum Zitat Allison RS, Millar JH. Prevalence of disseminated sclerosis in Northern Ireland. Ulster Med J. 1954;23:1–27.PubMed Allison RS, Millar JH. Prevalence of disseminated sclerosis in Northern Ireland. Ulster Med J. 1954;23:1–27.PubMed
9.
Zurück zum Zitat Broman T, Bergmann L, Fog T, Gilland O, Hyllested K, Lindberg-Broman AM, et al. Aspects on classification methods in multiple sclerosis. Acta Neurol Scand Suppl. 1965;13 Pt 2:543–8.PubMed Broman T, Bergmann L, Fog T, Gilland O, Hyllested K, Lindberg-Broman AM, et al. Aspects on classification methods in multiple sclerosis. Acta Neurol Scand Suppl. 1965;13 Pt 2:543–8.PubMed
10.
Zurück zum Zitat Schumacher GA, Beebe G, Kibler RF, Kurland LT, Kurtzke JF, Mcdowell F, et al. Problems of experimental trials of therapy in multiple sclerosis: report by the panel on the evaluation of experimental trials of therapy in multiple sclerosis. Ann N Y Acad Sci. 1965;122:552–68.CrossRefPubMed Schumacher GA, Beebe G, Kibler RF, Kurland LT, Kurtzke JF, Mcdowell F, et al. Problems of experimental trials of therapy in multiple sclerosis: report by the panel on the evaluation of experimental trials of therapy in multiple sclerosis. Ann N Y Acad Sci. 1965;122:552–68.CrossRefPubMed
11.
Zurück zum Zitat Poser CM, Brinar VV. Diagnostic criteria for multiple sclerosis: an historical review. Clin Neurol Neurosurg. 2004;106:147–58.CrossRefPubMed Poser CM, Brinar VV. Diagnostic criteria for multiple sclerosis: an historical review. Clin Neurol Neurosurg. 2004;106:147–58.CrossRefPubMed
12.
Zurück zum Zitat Rose AS, Ellison GW, Myers LW, Tourtellotte WW. Criteria for the clinical diagnosis of multiple sclerosis. Neurology. 1976;26:20–2.CrossRefPubMed Rose AS, Ellison GW, Myers LW, Tourtellotte WW. Criteria for the clinical diagnosis of multiple sclerosis. Neurology. 1976;26:20–2.CrossRefPubMed
13.
Zurück zum Zitat McDonald WI, Halliday AM. Diagnosis and classification of multiple sclerosis. Br Med Bull. 1977;33:4–9.PubMed McDonald WI, Halliday AM. Diagnosis and classification of multiple sclerosis. Br Med Bull. 1977;33:4–9.PubMed
14.
Zurück zum Zitat Poser CM, Paty DW, Scheinberg L, McDonald WI, Davis FA, Ebers GC, et al. New diagnostic criteria for multiple sclerosis: guidelines for research protocols. Ann Neurol. 1983;13:227–31.CrossRefPubMed Poser CM, Paty DW, Scheinberg L, McDonald WI, Davis FA, Ebers GC, et al. New diagnostic criteria for multiple sclerosis: guidelines for research protocols. Ann Neurol. 1983;13:227–31.CrossRefPubMed
15.
Zurück zum Zitat Izquierdo G, Hauw JJ, Lyon-Caen O, Marteau R, Escourolle R, Buge A, et al. Value of multiple sclerosis diagnostic criteria. 70 autopsy-confirmed cases. Arch Neurol. 1985;42:848–50.CrossRefPubMed Izquierdo G, Hauw JJ, Lyon-Caen O, Marteau R, Escourolle R, Buge A, et al. Value of multiple sclerosis diagnostic criteria. 70 autopsy-confirmed cases. Arch Neurol. 1985;42:848–50.CrossRefPubMed
16.
Zurück zum Zitat Engell T. A clinico-pathoanatomical study of multiple sclerosis diagnosis. Acta Neurol Scand. 1988;78:39–44.CrossRefPubMed Engell T. A clinico-pathoanatomical study of multiple sclerosis diagnosis. Acta Neurol Scand. 1988;78:39–44.CrossRefPubMed
17.
Zurück zum Zitat McDonald WI, Compston A, Edan G, Goodkin D, Hartung HP, Lublin FD, et al. Recommended diagnostic criteria for multiple sclerosis: Guidelines from the International Panel on the Diagnosis of Multiple Sclerosis. Ann Neurol. 2001;50:121–7.CrossRefPubMed McDonald WI, Compston A, Edan G, Goodkin D, Hartung HP, Lublin FD, et al. Recommended diagnostic criteria for multiple sclerosis: Guidelines from the International Panel on the Diagnosis of Multiple Sclerosis. Ann Neurol. 2001;50:121–7.CrossRefPubMed
18.
Zurück zum Zitat Polman CH, Reingold SC, Edan G, Filippi M, Hartung HP, Kappos L, et al. Diagnostic criteria for multiple sclerosis: 2005 revisions to the “McDonald Criteria.” Ann Neurol. 2005;58:840–6. doi:10.1002/ana.20703. Polman CH, Reingold SC, Edan G, Filippi M, Hartung HP, Kappos L, et al. Diagnostic criteria for multiple sclerosis: 2005 revisions to the “McDonald Criteria.” Ann Neurol. 2005;58:840–6. doi:10.​1002/​ana.​20703.
19.
Zurück zum Zitat Polman CH, Reingold SC, Banwell B, Clanet M, Cohen JA, Filippi M, et al. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann. Neurol. Wiley Subscription Services, Inc. A Wiley Company. 2011;69:292–302. Polman CH, Reingold SC, Banwell B, Clanet M, Cohen JA, Filippi M, et al. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann. Neurol. Wiley Subscription Services, Inc. A Wiley Company. 2011;69:292–302.
20.
Zurück zum Zitat Swanton JK, Rovira A, Tintore M, Altmann DR, Barkhof F, Filippi M, et al. MRI criteria for multiple sclerosis in patients presenting with clinically isolated syndromes: a multicentre retrospective study. Lancet Neurol. 2007;6:677–86.CrossRefPubMed Swanton JK, Rovira A, Tintore M, Altmann DR, Barkhof F, Filippi M, et al. MRI criteria for multiple sclerosis in patients presenting with clinically isolated syndromes: a multicentre retrospective study. Lancet Neurol. 2007;6:677–86.CrossRefPubMed
21.
Zurück zum Zitat Dalton CM, Brex PA, Miszkiel KA, Hickman SJ, MacManus DG, Plant GT, et al. Application of the new Mcdonald criteria to patients with clinically isolated syndromes suggestive of multiple sclerosis. Ann Neurol. 2002;52:47–53.CrossRefPubMed Dalton CM, Brex PA, Miszkiel KA, Hickman SJ, MacManus DG, Plant GT, et al. Application of the new Mcdonald criteria to patients with clinically isolated syndromes suggestive of multiple sclerosis. Ann Neurol. 2002;52:47–53.CrossRefPubMed
22.
Zurück zum Zitat Pia SM. The Will Rogers phenomenon: the effect of different diagnostic criteria. J Neurol Sci Elsevier. 2009;287:S46–9.CrossRef Pia SM. The Will Rogers phenomenon: the effect of different diagnostic criteria. J Neurol Sci Elsevier. 2009;287:S46–9.CrossRef
23.
Zurück zum Zitat Sormani MP, Tintorè M, Rovaris M, Rovira A, Vidal X, Bruzzi P, et al. Will Rogers phenomenon in multiple sclerosis. Ann Neurol. 2008;64:428–33.CrossRefPubMed Sormani MP, Tintorè M, Rovaris M, Rovira A, Vidal X, Bruzzi P, et al. Will Rogers phenomenon in multiple sclerosis. Ann Neurol. 2008;64:428–33.CrossRefPubMed
24.
Zurück zum Zitat Frohman EM, Balcer LJ, Calabresi PA. Multiple sclerosis: can retinal imaging accurately detect optic neuritis? Nat Rev Neurol. 2010;6:125–6.CrossRefPubMed Frohman EM, Balcer LJ, Calabresi PA. Multiple sclerosis: can retinal imaging accurately detect optic neuritis? Nat Rev Neurol. 2010;6:125–6.CrossRefPubMed
25.
Zurück zum Zitat Calabrese M, De Stefano N, Atzori M, et al. DEtection of cortical inflammatory lesions by double inversion recovery magnetic resonance imaging in patients with multiple sclerosis. Arch Neurol. 2007;64:1416–22.CrossRefPubMed Calabrese M, De Stefano N, Atzori M, et al. DEtection of cortical inflammatory lesions by double inversion recovery magnetic resonance imaging in patients with multiple sclerosis. Arch Neurol. 2007;64:1416–22.CrossRefPubMed
26.
Zurück zum Zitat Calabrese M, Rocca MA, Atzori M, Mattisi I, Bernardi V, Favaretto A, et al. Cortical lesions in primary progressive multiple sclerosis: a 2-year longitudinal MR study. Neurology. 2009;72:1330–6.CrossRefPubMed Calabrese M, Rocca MA, Atzori M, Mattisi I, Bernardi V, Favaretto A, et al. Cortical lesions in primary progressive multiple sclerosis: a 2-year longitudinal MR study. Neurology. 2009;72:1330–6.CrossRefPubMed
27.
Zurück zum Zitat Calabrese M, Rocca MA, Atzori M, Mattisi I, Favaretto A, Perini P, et al. A 3-year magnetic resonance imaging study of cortical lesions in relapse-onset multiple sclerosis. Ann Neurol. 2010;67:376–83.PubMed Calabrese M, Rocca MA, Atzori M, Mattisi I, Favaretto A, Perini P, et al. A 3-year magnetic resonance imaging study of cortical lesions in relapse-onset multiple sclerosis. Ann Neurol. 2010;67:376–83.PubMed
28.
Zurück zum Zitat Filippi M, Rocca MA, Calabrese M, Sormani MP, Rinaldi F, Perini P, et al. Intracortical lesions: relevance for new MRI diagnostic criteria for multiple sclerosis. Neurology. 2010;75:1988–94.CrossRefPubMed Filippi M, Rocca MA, Calabrese M, Sormani MP, Rinaldi F, Perini P, et al. Intracortical lesions: relevance for new MRI diagnostic criteria for multiple sclerosis. Neurology. 2010;75:1988–94.CrossRefPubMed
29.
Zurück zum Zitat Harel A, Ceccarelli A, Farrell C, Fabian M, Howard J, Riley C, et al. Phase-sensitive inversion-recovery mri improves longitudinal cortical lesion detection in progressive MS. PLoS One. 2016;11:e0152180.CrossRefPubMedPubMedCentral Harel A, Ceccarelli A, Farrell C, Fabian M, Howard J, Riley C, et al. Phase-sensitive inversion-recovery mri improves longitudinal cortical lesion detection in progressive MS. PLoS One. 2016;11:e0152180.CrossRefPubMedPubMedCentral
30.
Zurück zum Zitat Rocca MA, Agosta F, Sormani MP, Fernando K, Tintorè M, Korteweg T, et al. A three-year, multi-parametric MRI study in patients at presentation with CIS. J Neurol. 2008;255:683–91.CrossRefPubMed Rocca MA, Agosta F, Sormani MP, Fernando K, Tintorè M, Korteweg T, et al. A three-year, multi-parametric MRI study in patients at presentation with CIS. J Neurol. 2008;255:683–91.CrossRefPubMed
31.
Zurück zum Zitat Filippi M. In-vivo tissue characterization of multiple sclerosis and other white matter diseases using magnetic resonance based techniques. J Neurol. 2001;248:1019–29.CrossRefPubMed Filippi M. In-vivo tissue characterization of multiple sclerosis and other white matter diseases using magnetic resonance based techniques. J Neurol. 2001;248:1019–29.CrossRefPubMed
32.
33.
Zurück zum Zitat Brettschneider J, Jaskowski TD, Tumani H, Abdul S, Husebye D, Seraj H, et al. Serum anti-GAGA4 IgM antibodies differentiate relapsing remitting and secondary progressive multiple sclerosis from primary progressive multiple sclerosis and other neurological diseases. J Neuroimmunol. 2009;217:95–101.CrossRefPubMed Brettschneider J, Jaskowski TD, Tumani H, Abdul S, Husebye D, Seraj H, et al. Serum anti-GAGA4 IgM antibodies differentiate relapsing remitting and secondary progressive multiple sclerosis from primary progressive multiple sclerosis and other neurological diseases. J Neuroimmunol. 2009;217:95–101.CrossRefPubMed
34.
Zurück zum Zitat Quintana FJ, Farez MF, Viglietta V, Iglesias AH, Merbl Y, Izquierdo G, et al. Antigen microarrays identify unique serum autoantibody signatures in clinical and pathologic subtypes of multiple sclerosis. Proc Natl Acad Sci U S A. 2008;105:18889–94.CrossRefPubMedPubMedCentral Quintana FJ, Farez MF, Viglietta V, Iglesias AH, Merbl Y, Izquierdo G, et al. Antigen microarrays identify unique serum autoantibody signatures in clinical and pathologic subtypes of multiple sclerosis. Proc Natl Acad Sci U S A. 2008;105:18889–94.CrossRefPubMedPubMedCentral
35.
Zurück zum Zitat Keller A, Leidinger P, Lange J, Borries A, Schroers H, Scheffler M, et al. Multiple sclerosis: microRNA expression profiles accurately differentiate patients with relapsing-remitting disease from healthy controls. Martin DP, editor. PLoS One. Public Library of Science; 2009;4:e7440. Keller A, Leidinger P, Lange J, Borries A, Schroers H, Scheffler M, et al. Multiple sclerosis: microRNA expression profiles accurately differentiate patients with relapsing-remitting disease from healthy controls. Martin DP, editor. PLoS One. Public Library of Science; 2009;4:e7440.
36.
Zurück zum Zitat Srivastava R, Aslam M, Kalluri SR, Schirmer L, Buck D, Tackenberg B, et al. Potassium channel KIR4.1 as an immune target in multiple sclerosis. N Engl J Med. 2012;367:115–23.CrossRefPubMed Srivastava R, Aslam M, Kalluri SR, Schirmer L, Buck D, Tackenberg B, et al. Potassium channel KIR4.1 as an immune target in multiple sclerosis. N Engl J Med. 2012;367:115–23.CrossRefPubMed
37.
Zurück zum Zitat Granberg T, Martola J, Kristoffersen-Wiberg M, Aspelin P, Fredrikson S. Radiologically isolated syndrome—incidental magnetic resonance imaging findings suggestive of multiple sclerosis, a systematic review. Mult Scler. 2013;19:271–80.CrossRefPubMed Granberg T, Martola J, Kristoffersen-Wiberg M, Aspelin P, Fredrikson S. Radiologically isolated syndrome—incidental magnetic resonance imaging findings suggestive of multiple sclerosis, a systematic review. Mult Scler. 2013;19:271–80.CrossRefPubMed
38.
Zurück zum Zitat Okuda DT, Siva A, Kantarci O, Inglese M, Katz I, Tutuncu M, et al. Radiologically isolated syndrome: 5-year risk for an initial clinical event. PLoS One. 2014;9:e90509.CrossRefPubMedPubMedCentral Okuda DT, Siva A, Kantarci O, Inglese M, Katz I, Tutuncu M, et al. Radiologically isolated syndrome: 5-year risk for an initial clinical event. PLoS One. 2014;9:e90509.CrossRefPubMedPubMedCentral
39.
Zurück zum Zitat Lebrun. The radiologically isolated syndrome Le syndrome radiologique isole. Rev. Neurol. (Paris). 2015;171:698–706. Lebrun. The radiologically isolated syndrome Le syndrome radiologique isole. Rev. Neurol. (Paris). 2015;171:698–706.
40.
Zurück zum Zitat Okuda DT, Mowry EM, Beheshtian A, Waubant E, Baranzini SE, Goodin DS, et al. Incidental MRI anomalies suggestive of multiple sclerosis: the radiologically isolated syndrome. Neurology. 2009;72:800–5.CrossRefPubMed Okuda DT, Mowry EM, Beheshtian A, Waubant E, Baranzini SE, Goodin DS, et al. Incidental MRI anomalies suggestive of multiple sclerosis: the radiologically isolated syndrome. Neurology. 2009;72:800–5.CrossRefPubMed
41.
Zurück zum Zitat Whitaker JN, McFarland HF, Rudge P, Reingold SC. Outcomes assessment in multiple sclerosis clinical trials: a critical analysis. Mult Scler. 1995;1:37–47.PubMed Whitaker JN, McFarland HF, Rudge P, Reingold SC. Outcomes assessment in multiple sclerosis clinical trials: a critical analysis. Mult Scler. 1995;1:37–47.PubMed
42.
Zurück zum Zitat Lublin FD, Reingold SC. Defining the clinical course of multiple sclerosis: results of an international survey. National Multiple Sclerosis Society (USA) Advisory Committee on Clinical Trials of New Agents in Multiple Sclerosis. Neurology. 1996;46:907–11.CrossRefPubMed Lublin FD, Reingold SC. Defining the clinical course of multiple sclerosis: results of an international survey. National Multiple Sclerosis Society (USA) Advisory Committee on Clinical Trials of New Agents in Multiple Sclerosis. Neurology. 1996;46:907–11.CrossRefPubMed
43.•
Zurück zum Zitat Lublin FD, Reingold SC, Cohen JA, Cutter GR, Sørensen PS, Thompson AJ, et al. Defining the clinical course of multiple sclerosis: the 2013 revisions. Neurology. 2014;83:278–86. The new multiple scleroris clinical course classifications.CrossRefPubMedPubMedCentral Lublin FD, Reingold SC, Cohen JA, Cutter GR, Sørensen PS, Thompson AJ, et al. Defining the clinical course of multiple sclerosis: the 2013 revisions. Neurology. 2014;83:278–86. The new multiple scleroris clinical course classifications.CrossRefPubMedPubMedCentral
44.
Zurück zum Zitat IFN Study Group. Interferon beta-1b is effective in relapsing-remitting multiple sclerosis. I. Clinical results of a multicenter, randomized, double-blind, placebo-controlled trial. The IFNB Multiple Sclerosis Study Group. Neurology. 1993;43:655–61.CrossRef IFN Study Group. Interferon beta-1b is effective in relapsing-remitting multiple sclerosis. I. Clinical results of a multicenter, randomized, double-blind, placebo-controlled trial. The IFNB Multiple Sclerosis Study Group. Neurology. 1993;43:655–61.CrossRef
45.
Zurück zum Zitat Fred L. History of modern multiple sclerosis therapy. J Neurol. 2005;252:3–9.CrossRef Fred L. History of modern multiple sclerosis therapy. J Neurol. 2005;252:3–9.CrossRef
46.•
Zurück zum Zitat Imitola J, Racke MMK, LK F, CJ B, DL R, RA N, et al. Is No Evidence of Disease Activity a Realistic Goal for Patients With Multiple Sclerosis? JAMA Neurol. American Medical Association; 2014;72:22–4. A great review about the current treatment goals of multiple sclerosis therapy. Imitola J, Racke MMK, LK F, CJ B, DL R, RA N, et al. Is No Evidence of Disease Activity a Realistic Goal for Patients With Multiple Sclerosis? JAMA Neurol. American Medical Association; 2014;72:22–4. A great review about the current treatment goals of multiple sclerosis therapy.
47.
Zurück zum Zitat Bevan CJ, Cree BAC, JK A, E H, G G, LRE-W K, et al. Disease activity free status. JAMA Neurol. American Medical Association; 2014;71:269. Bevan CJ, Cree BAC, JK A, E H, G G, LRE-W K, et al. Disease activity free status. JAMA Neurol. American Medical Association; 2014;71:269.
48.
Zurück zum Zitat Havrdova E, Galetta S, Hutchinson M, Stefoski D, Bates D, Polman CH, et al. Effect of natalizumab on clinical and radiological disease activity in multiple sclerosis: a retrospective analysis of the Natalizumab Safety and Efficacy in Relapsing-Remitting Multiple Sclerosis (AFFIRM) study. Lancet Neurol. 2009;8:254–60.CrossRefPubMed Havrdova E, Galetta S, Hutchinson M, Stefoski D, Bates D, Polman CH, et al. Effect of natalizumab on clinical and radiological disease activity in multiple sclerosis: a retrospective analysis of the Natalizumab Safety and Efficacy in Relapsing-Remitting Multiple Sclerosis (AFFIRM) study. Lancet Neurol. 2009;8:254–60.CrossRefPubMed
49.
Zurück zum Zitat Trojano M. Multiple sclerosis: the evolving diagnostic criteria for multiple sclerosis. Nat Rev Neurol Nature Publishing Group. 2011;7:251–2.CrossRef Trojano M. Multiple sclerosis: the evolving diagnostic criteria for multiple sclerosis. Nat Rev Neurol Nature Publishing Group. 2011;7:251–2.CrossRef
Metadaten
Titel
Diagnostic Criteria, Classification and Treatment Goals in Multiple Sclerosis: The Chronicles of Time and Space
verfasst von
Achilles Ntranos
Fred Lublin
Publikationsdatum
01.10.2016
Verlag
Springer US
Erschienen in
Current Neurology and Neuroscience Reports / Ausgabe 10/2016
Print ISSN: 1528-4042
Elektronische ISSN: 1534-6293
DOI
https://doi.org/10.1007/s11910-016-0688-8

Weitere Artikel der Ausgabe 10/2016

Current Neurology and Neuroscience Reports 10/2016 Zur Ausgabe

Epilepsy (CW Bazil, Section Editor)

Recent Advances in Neonatal Seizures

Critical Care (SA Mayer, Section Editor)

Post-Craniotomy Pain Management: Beyond Opioids

Leitlinien kompakt für die Neurologie

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Hirnblutung unter DOAK und VKA ähnlich bedrohlich

17.05.2024 Direkte orale Antikoagulanzien Nachrichten

Kommt es zu einer nichttraumatischen Hirnblutung, spielt es keine große Rolle, ob die Betroffenen zuvor direkt wirksame orale Antikoagulanzien oder Marcumar bekommen haben: Die Prognose ist ähnlich schlecht.

Was nützt die Kraniektomie bei schwerer tiefer Hirnblutung?

17.05.2024 Hirnblutung Nachrichten

Eine Studie zum Nutzen der druckentlastenden Kraniektomie nach schwerer tiefer supratentorieller Hirnblutung deutet einen Nutzen der Operation an. Für überlebende Patienten ist das dennoch nur eine bedingt gute Nachricht.

Thrombektomie auch bei großen Infarkten von Vorteil

16.05.2024 Ischämischer Schlaganfall Nachrichten

Auch ein sehr ausgedehnter ischämischer Schlaganfall scheint an sich kein Grund zu sein, von einer mechanischen Thrombektomie abzusehen. Dafür spricht die LASTE-Studie, an der Patienten und Patientinnen mit einem ASPECTS von maximal 5 beteiligt waren.

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.