Inpatient Consultations in Neurology

Pria Anand, MD

Joshua P. Klein, MD, PhD

In 1906, Santiago Ramón y Cajal described the brain as “a world consisting of a number of unexplored continents and great stretches of unknown territory.”[1] In the century since, Ramón y Cajal and his intellectual successors have made remarkable headway in mapping the endlessly complex terrain of the nervous system. As a result, a host of new and diverse neurologic and neuro-medical syndromes have been characterized and, in parallel, an ever-expanding list of novel therapeutics is now available to treat our patients.

As the neurologic landscape continues to evolve, neurologists are also grappling with the increasing recognition that timely in-hospital consultation is very often essential to diagnose, treat, and minimize neurologic morbidity and mortality. Indeed, every year, nearly one million patients are hospitalized with a non-surgical neurologic diagnosis.[2] Their acute neurologic syndromes – stroke, status epilepticus, encephalitis, myelitis, delirium, and neuromuscular failure, to name a few – span every subspeciality, rendering diagnosis and management in the inpatient setting a highly collaborative endeavor that presents distinct challenges and opportunities for the hospital neurologist.

With this issue of Seminars in Neurology, we hope to offer readers a concise yet comprehensive guide to the spectrum of common inpatient neurologic consultations. Each article distills a complex question (for instance, “How should we approach the palliative care needs of inpatients with neurologic illness?” or, “What factors should be considered when prognosticating after cardiac arrest?”) into a practical approach. Of course, many of the topics covered here represent areas of active investigation within a field that is itself rapidly evolving. As such, this issue can serve not only as a reference for current practice, but also as a snapshot of the state of the art of hospital neurology in 2021.

We are indebted to the contributing authors, who have been profoundly generous with their time and expertise in the creation of this issue. We are also deeply grateful to Drs. David Greer and Ariane Lewis, the Editor-in-Chief and Deputy Editor of Seminars in Neurology. Thank you for entrusting us with this issue, and for the immeasurable encouragement, support, and guidance along the way.

Publikationsverlauf

Artikel online veröffentlicht:
07. Oktober 2021

• References

• 1 Breedlove B. Unexplored continents and great stretches of unknown territory. Emerg Infect Dis 2017; 23 (06) 1052-1053
• 2 Josephson SA, Engstrom JW, Wachter RM. Neurohospitalists: an emerging model for inpatient neurological care. Ann Neurol 2008; 63 (02) 135-140