會議議程
講者簡介
2022/8/13 14:10-17:40 Room A Hall (第一會議室) 2F
- Plenary Session
- Time
- Topic
- Speaker
- Moderator
- 14:10~14:50
- Critical Care Neurology and Curing Coma
- Speaker:
Jan Claassen
- Moderator:
林永煬
- Professor Jan Claassen
- MD
-
Chief, Division of Critical Care & Hospitalist Neurology
Columbia University, New York, NY, USA
E-mail：jc1439@cumc.columbia.edu
Executive Summary：
Dr. Claassen is an Associate Professor of Neurology and the Director of Critical Care Neurology at Columbia University. He is an Associate Attending Physician at NewYork-Presbyterian/Columbia University Medical Center and the Medical Director of the Neurocritical Care Unit. Dr. Claassen received his medical degree from the University of Hamburg, Germany, and completed residency training in Neurology, and Fellowship training in Neurocritical Care and Epilepsy at Columbia University. He is board certified in Neurology and Neurocritical Care.
Dr Claassen is a nationally and internationally recognized expert in the treatment of neurological intensive care. He is an expert in coma, status epilepticus and brain hemorrhages. He served on the board of directors and as the co-chair for guidelines development for the Neurocritical Care Society. He has championed the use of innovative brain monitoring techniques including continuous EEG monitoring. His sits on the editorial board of Annals of Neurology and Neurocritical Care.
Dr Claassen’s research characterizes physiologic changes following acute brain injury, focusing on novel treatment approaches to potentially improve patient outcomes. He is a widely recognized expert on disorders of consciousness. He has published more than 300 journal articles, book chapters, and reviews. He is the co-editor of the seminal monograph Plum and Posner’s: Diagnosis and Treatment of Stupor and Coma. His research is supported by federal R01 and foundation grants
Areas of Expertise / Conditions Treated
Encephalitis Epileptic Seizures Intracerebral Hemorrhage Meningitis Spinal Cord Injury Subarachnoid Hemorrhage Transient Ischemic Attacks/ TIA Traumatic Brain Injury
Academic Appointments
Associate Professor of Neurology at CUMC
Administrative Titles
Head of Neurocritical Care and Medical Director of the Neurological Intensive Care Unit
Chief, Critical Care and Hospitalist Neurology
Hospital Affiliations
NewYork-Presbyterian / Columbia University Irving Medical Center
Dr. Claassen is an Associate Professor of Neurology and the Director of Critical Care Neurology at Columbia University. He is an Associate Attending Physician at NewYork-Presbyterian/Columbia University Medical Center and the Medical Director of the Neurocritical Care Unit. Dr. Claassen received his medical degree from the University of Hamburg, Germany, and completed residency training in Neurology, and Fellowship training in Neurocritical Care and Epilepsy at Columbia University. He is board certified in Neurology and Neurocritical Care.
Dr Claassen is a nationally and internationally recognized expert in the treatment of neurological intensive care. He is an expert in coma, status epilepticus and brain hemorrhages. He served on the board of directors and as the co-chair for guidelines development for the Neurocritical Care Society. He has championed the use of innovative brain monitoring techniques including continuous EEG monitoring. His sits on the editorial board of Annals of Neurology and Neurocritical Care.
Dr Claassen’s research characterizes physiologic changes following acute brain injury, focusing on novel treatment approaches to potentially improve patient outcomes. He is a widely recognized expert on disorders of consciousness. He has published more than 300 journal articles, book chapters, and reviews. He is the co-editor of the seminal monograph Plum and Posner’s: Diagnosis and Treatment of Stupor and Coma. His research is supported by federal R01 and foundation grants
Areas of Expertise / Conditions Treated
Encephalitis Epileptic Seizures Intracerebral Hemorrhage Meningitis Spinal Cord Injury Subarachnoid Hemorrhage Transient Ischemic Attacks/ TIA Traumatic Brain Injury
Academic Appointments
Associate Professor of Neurology at CUMC
Administrative Titles
Head of Neurocritical Care and Medical Director of the Neurological Intensive Care Unit
Chief, Critical Care and Hospitalist Neurology
Hospital Affiliations
NewYork-Presbyterian / Columbia University Irving Medical Center
Lecture Abstract：
Coma is common after acute brain injury, but exact epidemiological data is missing. Neuroanatomical models have implicated the ascending arousal system that originates in the brainstem, with carefully identified neurotransmitters, the anterior forebrain mesocircuit in which the central thalamic nuclei take a prominent role, and widespread cortical networks. How cortical networks organize to support a conscious experience is not completely understood but a number of theories such as the global workspace and information theory have been put forward. Many pathologies may lead to coma. These are broadly categorized into supratentorial structural lesions, infratentorial structural lesions, metabolic/non-structural pathology, and psychogenic causes. The goal of the physician encountering a comatose patient emergently is rapidly identify the most likely and most concerning cause for coma that is addressable. The neurological examination has to be focused with keeping these efforts in mind. Recovery may be delayed, which should be kept in mind as the vast majority of comatose patients with acute brain injury die from withdrawal of life sustaining therapies. However, our ability to accurately predict recovery is limited. Emerging technology such as the task-based MRI or EEG supported diagnosis of cognitive motor dissociation may allow more precise predictions of recovery. Patients with cognitive motor dissociation show willful modulation of brain activity that is detected with functional MRI or EEG, but the patient does not display any behavioral evidence of command following. The Curing Coma Campaign is a worldwide collaboration of scientists that have come together to develop treatments that support recovery of comatose patients (https://www.curingcoma.org/home).
Coma is common after acute brain injury, but exact epidemiological data is missing. Neuroanatomical models have implicated the ascending arousal system that originates in the brainstem, with carefully identified neurotransmitters, the anterior forebrain mesocircuit in which the central thalamic nuclei take a prominent role, and widespread cortical networks. How cortical networks organize to support a conscious experience is not completely understood but a number of theories such as the global workspace and information theory have been put forward. Many pathologies may lead to coma. These are broadly categorized into supratentorial structural lesions, infratentorial structural lesions, metabolic/non-structural pathology, and psychogenic causes. The goal of the physician encountering a comatose patient emergently is rapidly identify the most likely and most concerning cause for coma that is addressable. The neurological examination has to be focused with keeping these efforts in mind. Recovery may be delayed, which should be kept in mind as the vast majority of comatose patients with acute brain injury die from withdrawal of life sustaining therapies. However, our ability to accurately predict recovery is limited. Emerging technology such as the task-based MRI or EEG supported diagnosis of cognitive motor dissociation may allow more precise predictions of recovery. Patients with cognitive motor dissociation show willful modulation of brain activity that is detected with functional MRI or EEG, but the patient does not display any behavioral evidence of command following. The Curing Coma Campaign is a worldwide collaboration of scientists that have come together to develop treatments that support recovery of comatose patients (https://www.curingcoma.org/home).