title: Management of neuro-oncologic emergencies.
abstract: Patients with brain tumors and systemic malignancies are subject to diverse neurologic complications that require urgent evaluation and treatment. These neurologic conditions are commonly due to the tumor's direct effects on the nervous system, such as cerebral edema, increased intracranial pressure, seizures, spinal cord compression, and leptomeningeal metastases. In addition, neurologic complications can develop as a result of thrombocytopenia, coagulopathy, hyperviscosity syndromes, infection, immune-related disorders, and adverse effects of treatment. Patients may present with typical disease syndromes. However, it is not uncommon for patients to have more subtle, nonlocalizing manifestations, such as alteration of mental status, that could be attributed to other systemic, nonneurologic complications. Furthermore, neurologic complications are at times the initial manifestations of an undiagnosed malignancy. Therefore a high index of suspicion is essential for rapid assessment and management. Timely intervention may prolong survival and improve quality of life. In this chapter, we will discuss the common neuro-oncologic emergencies, including epidemiology, pathophysiology, clinical presentation, diagnosis, and treatment.
authors.affiliation: Neuro-Oncology Center, University of Virginia, Charlottesville, VA, USA.
authors.forename: J T
authors.initials: JT
authors.lastname: Jo
authors.affiliation: Neuro-Oncology Center, University of Virginia, Charlottesville, VA, USA. Electronic address: ds4jd@virginia.edu.
authors.forename: D
authors.initials: D
authors.lastname: Schiff
mesh_terms: D001932:Brain Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D019468:Disease Management; D006801:Humans; D008495:Medical Oncology; D009462:Neurology
keywords: CNS infection; cerebral edema; chemotherapy-induced neuropathy; hyperviscosity syndrome; leptomeningeal metastases; paraneoplastic disorders; radiation necrosis; spinal cord compression; tumor-associated epilepsy