2024 AANS Neurosurgical Topics for APPs - On-Demand-Balancing Act: Understanding Neurologic Complications in Emerging Alzheimer's Treatments -Karen Greenberg

Balancing Act: Understanding Neurologic Complications in Emerging Alzheimer's Treatments -Karen Greenberg

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Video Summary

Dr. Karen Greenberg, an emergency and neurocritical care physician, presented a detailed discussion on the emerging topic of amyloid-targeting therapies (ATT) and associated complications, particularly relevant for Alzheimer's patients. Despite Alzheimer's traditionally being a medical issue, Dr. Greenberg emphasized the critical role these treatments play in emergency and surgical settings, given they may cause amyloid-related imaging abnormalities (ARIA) presenting as cerebral edema or hemorrhage.<br /><br />ATTs are administered as intravenous antibody infusions aimed at reducing amyloid-beta plaques in the brain. While these treatments slow disease progression, they also weaken the blood-brain barrier, leading to substantial risks, including ARIA. In clinical trials, ARIA was noted in as many as one in three patients, sometimes causing severe outcomes, including fatalities.<br /><br />Dr. Greenberg stressed the significance of recognizing ARIA symptoms—a process requiring MRI over standard CT scans—and the potential risks of anticoagulation in patients on ATT, highlighting the necessity for heightened awareness among healthcare professionals. She advocated for multidisciplinary approaches and specific precautionary measures, like medical alert bracelets for patients, to enhance the management and safety of these new therapies.

Keywords

amyloid-targeting therapies

Alzheimer's disease

amyloid-related imaging abnormalities

emergency care

neurocritical care

blood-brain barrier

multidisciplinary approaches