Neuro-oncological emergencies requiring critical care intervention.
- 1Department of Neurology (Neurocritical Care), Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA. Electronic address: [email protected].
- 2Department of Neurology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA.
- 3Division of Neurocritical Care, Department of Neurology, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
Abstract
Patients with primary or metastatic brain tumours can deteriorate abruptly, and the acute physician is often the first to respond. This review covers the recognition and initial management of the neurological emergencies most likely to need critical care: raised intracranial pressure from peritumoural oedema and herniation; seizures and status epilepticus, including non-convulsive status epilepticus (NCSE); intracranial haemorrhage; acute hydrocephalus; and venous thromboembolism. It also covers two treatment-related emergencies that the general physician must now recognise: immune effector cell-associated neurotoxicity syndrome after chimeric antigen receptor (CAR) T-cell therapy, and immune checkpoint inhibitor encephalitis. Throughout, the text indicates whether recommendations rest on guidelines and where on observational data. The focus is on recognising time-critical treatment, timely escalation to neurosurgical and neurocritical care services, and the early, values-based discussion of goals of care.
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BibTeX
@article{kornbluth2026neurooncological,
title = {{Neuro-oncological emergencies requiring critical care intervention.}},
author = {Joshua A Kornbluth and Jessica Wallace and David Y Hwang},
journal = {Clinical medicine (London, England)},
year = {2026},
month = oct,
doi = {10.1016/j.clinme.2026.100653},
url = {https://europepmc.org/article/MED/42838418},
note = {CC BY},
}
RIS
TY - JOUR
TI - Neuro-oncological emergencies requiring critical care intervention.
AU - Joshua A Kornbluth
AU - Jessica Wallace
AU - David Y Hwang
PY - 2026
DA - 2026/10/06
JO - Clinical medicine (London, England)
DO - 10.1016/j.clinme.2026.100653
UR - https://europepmc.org/article/MED/42838418
AB - Patients with primary or metastatic brain tumours can deteriorate abruptly, and the acute physician is often the first to respond. This review covers the recognition and initial management of the neurological emergencies most likely to need critical care: raised intracranial pressure from peritumoural oedema and herniation; seizures and status epilepticus, including non-convulsive status epilepticus (NCSE); intracranial haemorrhage; acute hydrocephalus; and venous thromboembolism. It also covers two treatment-related emergencies that the general physician must now recognise: immune effector cell-associated neurotoxicity syndrome after chimeric antigen receptor (CAR) T-cell therapy, and immune checkpoint inhibitor encephalitis. Throughout, the text indicates whether recommendations rest on guidelines and where on observational data. The focus is on recognising time-critical treatment, timely escalation to neurosurgical and neurocritical care services, and the early, values-based discussion of goals of care.
SN - 1470-2118
SN - 1473-4893
ER -