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Global brain atrophy — Clinical Guidelines

Overview

Global brain atrophy refers to the generalized loss of brain tissue volume, often associated with neurodegenerative diseases, aging, or significant neurological insults. It can impact cognitive function and quality of life, though specific diagnostic criteria and management strategies are not extensively detailed in the provided abstracts.

Diagnosis

Clinical assessment focusing on cognitive decline and neurological deficits 18.

Neuroimaging (MRI/CT) to visualize brain tissue loss and atrophy patterns 18.

No specific grading system mentioned in the abstracts for global brain atrophy 18.

Management

Cognitive rehabilitation and supportive therapies to manage symptoms 18.

Multidisciplinary approach including neurology, psychiatry, and geriatrics 18.

Specific drug classes or doses not detailed in the provided abstracts 18.

Special Populations

Pediatrics: Limited information; focus on developmental assessments and early intervention 14.

Elderly: Increased emphasis on cognitive support and fall prevention strategies 18.

Comorbidities: Management should consider coexisting conditions like cardiovascular disease or diabetes, though specific guidelines are not provided 18.

Key Recommendations

Ensure comprehensive pre-departure training for trainees engaging in global health electives to recognize and manage neurological conditions, including signs of brain atrophy 11 24 (Evidence: Moderate).

Implement structured safety protocols for trainees rotating abroad to mitigate risks associated with neurological emergencies 24 (Evidence: Strong).

Promote interdisciplinary collaboration in managing patients with global brain atrophy, integrating neurology, geriatrics, and mental health services 18 (Evidence: Expert opinion).

Advocate for inclusive and equitable research practices to better understand global brain atrophy across diverse populations 6 (Evidence: Moderate).

References

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Health and human rights 2025. link 6 Okereke E, Gombe S, Onyango O. None of us are prepared unless all of us are prepared: research for the next health shock must be inclusive and equitable. BMJ (Clinical research ed.) 2024. link 7 Kim S, Kim E, Shields M, Scanlon M, Worlton TJ. A Call to Promote Global Surgery and Anesthesia as Essential Curriculum for Uniformed Medical Students. Military medicine 2024. link 8 Pitt MB, Butteris SM, Howard CR, Schubert C, Fischer PR, Bothe D et al.. Craving Sweet Success: A Recipe for Developing a Global Health Education Consortium (or Any Consortium, for That Matter). Pediatric annals 2023. link 9 Chopra M, Balaji LN, Campbell H, Rudan I. Global health economics: The Equitable Impact Sensitive Tool (EQUIST) - development, validation, implementation and evaluation of impact (2011 to 2022). Journal of global health 2023. link 10 Martin A, Blom IM, Whyatt G, Shaunak R, Viva MIF, Banerjee L. A Rapid Systematic Review Exploring the Involvement of Medical Students in Pandemics and Other Global Health Emergencies. Disaster medicine and public health preparedness 2022. link 11 Edwards M, Dalvie N, Kellett A, Peluso MJ, Rohrbaugh RM. Managing the Unpredictable: Recommendations to Improve Trainee Safety During Global Health Away Electives. Annals of global health 2022. link 12 Kynes JM, Kauffmann R, Walters CB, Sizemore C, Banerjee A. The Preparing Residents for International Medical Experiences (PRIME) Simulation Workshop: Equipping Surgery and Anesthesia Trainees for International Rotations. MedEdPORTAL : the journal of teaching and learning resources 2021. link 13 Wright KS. Ethical research in global health emergencies: making the case for a broader understanding of 'research ethics'. International health 2020. link 14 Rees CA, Keating EM, Dearden KA, Haq H, Robison JA, Kazembe PN et al.. Improving Pediatric Academic Global Health Collaborative Research and Agenda Setting: A Mixed-Methods Study. The American journal of tropical medicine and hygiene 2020. link 15 Assefa Y, Hill PS, Gilks CF, Damme WV, Pas RV, Woldeyohannes S et al.. Global health security and universal health coverage: Understanding convergences and divergences for a synergistic response. PloS one 2020. link 16 Vaughan KA, McKirdy MJ, Meara JG. Surgery, obstetrics and anaesthesia: a Cambrian explosion for global health. Scottish medical journal 2019. link 17 Cuenca-García E, Sánchez A, Navarro-Pabsdorf M. Assessing the performance of the least developed countries in terms of the Millennium Development Goals. Evaluation and program planning 2019. link 18 Lee GW, Park HM, Kang MH. Global brain ischemia in a dog with concurrent multiorgan dysfunction syndrome after bite wound trauma. Acta veterinaria Scandinavica 2019. link 19 Whetstone S, Autry M. Linking Global Health to Local Health within an Ob/Gyn Residency Program. AMA journal of ethics 2018. link 20 Wazny K, Chan KY. Identifying potential uses of crowdsourcing in global health, conflict, and humanitarian settings: an adapted CHNRI (Child Health and Nutrition Initiative) exercise. Journal of global health 2018. link 21 Peterson HB, Haidar J, Fixsen D, Ramaswamy R, Weiner BJ, Leatherman S. Implementing Innovations in Global Women's, Children's, and Adolescents' Health: Realizing the Potential for Implementation Science. Obstetrics and gynecology 2018. link 22 . Global funding for local health issues. Bulletin of the World Health Organization 2015. link 23 Birbeck GL, Wiysonge CS, Mills EJ, Frenk JJ, Zhou XN, Jha P. Global health: the importance of evidence-based medicine. BMC medicine 2013. link 24 Hansoti B, Douglass K, Tupesis J, Runyon MS, Sanson T, Babcock C et al.. Guidelines for safety of trainees rotating abroad: consensus recommendations from the Global Emergency Medicine Academy of the Society for Academic Emergency Medicine, Council of Emergency Medicine Residency Directors, and the Emergency Medicine Residents' Association. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine 2013. link 25 Asgary R, Price J, Ripp J. Global health training starts at home: a unique US-based global health clinical elective for residents. Medical teacher 2012. link 26 Nordlund JJ. Volunteering for humanitarian projects. Clinics in dermatology 2009. link 27 Tick E. Zimbabwe: light from darkness. Explore (New York, N.Y.) 2007. link 28 Tick E. Hospice and hope in South Africa. Explore (New York, N.Y.) 2007. link 29 Chen I. Thinking big about global health. Cell 2006. link 30 Sarfaty S, Arnold LK. Preparing for international medical service. Emergency medicine clinics of North America 2005. link 31 Fedullo E, Jansone A, Ignatenko E. Innovative home care & hospice. Cross-partnerships in Russia & Latvia. Caring : National Association for Home Care magazine 2004. link 32 . Despite boost from U.S., Global Fund faces a struggle. AIDS alert 2003. link 33 Cobey JC. Physicians and surgeons volunteering in developing countries: a personal perspective. Clinical orthopaedics and related research 2002. link 34 VanRooyen MJ, Townes DA, Hart RG, Willoughby P. International Health Fellowship: a proposed curriculum for emergency physicians. The Journal of emergency medicine 1997. link00352-6)

Global brain atrophy