Rachel E Thompson MD MPH SFHM, James Maliszewski MD, Andrew Moellering MD, Urmila Mukherjee MD, Andjela Drincic MD, Christina Ryan MD, and Andrew Gard MD

If you are a Program Director and would like to grant access to your trainees, please reach out to education@hospitalmedicine.org for an academic access code.

SUMMARY

Comanagement of neurosurgery patients between surgeons and hospitalists is becoming more common, making it necessary for hospitalists to have a better understanding of potential neurosurgical presentations and complications. Common reasons for neurosurgery include subarachnoid hemorrhages (SAHs), acute subdural hematomas (SDHs), and brain tumors. The following module discusses the epidemiology, prognosis, and clinical course for patients presenting with SAH, as well as complications that occur and management strategies. Methods for predicting and managing SDH are examined, and a detailed discussion of the epidemiology and prognosis of common brain tumors is included.

GOAL

To provide hospitalists with up-to-date information about the potential presentation and management of complications in patients who require neurosurgery.

TARGET AUDIENCE

This activity is designed for hospitalists. 

LEARNING OBJECTIVES

After completing the module, the participant should be able to:

1. Summarize the epidemiology, clinical course, and prognosis of patients presenting with subarachnoid hemorrhage.
2. Recognize acute and chronic hydrocephalus and explain potential management strategies in the adult population.
3. Describe basic shunt structure and diagnose common shunt complications.
4. Identify predictors of outcome and describe the management of acute subdural hematoma.
5. Detail the epidemiology and prognosis for common brain tumors.
6. Summarize the epidemiology and classification of pituitary tumors and discuss the preoperative evaluation and postsurgical complications of water homeostasis disorders.
7. Develop a basic understanding of the more common endovascular neurosurgical procedures. 

ACCREDITATION STATEMENT

The Society of Hospital Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

CREDIT DESIGNATION STATEMENT

The Society of Hospital Medicine designated this activity for a maximum of 2.0 AMA PRA Category 1 Credits^TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Release date: October 31, 2017

Expiration date: October 31, 2020

Estimated time to complete activity: 2 hours

CONFLICT OF INTEREST DISCLOSURE POLICY

In accordance with the ACCME Standards for Commercial Support, SHM requires that individuals in a position to control the content of an educational activity disclose all relevant financial relationships with any commercial interest. SHM resolves all conflicts of interest to ensure independence, objectivity, balance, and scientific rigor in all its educational programs. All relevant financial relationships shall be disclosed to participants prior to the start of the activity.

Furthermore, SHM seeks to verify that all scientific research referred to, reported, or used in a continuing medical education (CME) activity conforms to the generally accepted standards of experimental design, data collection, and analysis. SHM is committed to providing its learners with high-quality CME activities that promote improvements in healthcare and not those of a commercial interest.

INSTRUCTIONS

The following is an interactive educational module designed to help you gauge your basic knowledge of the topic and then direct you to areas you may need to focus on. It consists of several sections: a pre-test, a study program & CME evaluation. All sections must be completed to receive CME credit.