图书简介

1. Pathophysiology of Signs and Symptoms of Coma; ALTERED STATES OF CONSCIOUSNESS; DEFINITIONS; Consciousness; Acutely Altered States of Consciousness; Subacute or Chronic Alterations of Consciousness; APPROACH TO THE DIAGNOSIS OF THE COMATOSE PATIENT; PHYSIOLOGY AND PATHOPHYSIOLOGY OF CONSCIOUSNESS AND COMA; The Ascending Arousal System; Behavioral State Switching; Relationship of Coma to Sleep; The Cerebral Hemispheres and Conscious Behavior; Structural Lesions That Cause Altered Consciousness in Humans; 2. Examination of the Comatose Patient; OVERVIEW; HISTORY; GENERAL PHYSICAL EXAMINATION; LEVEL OF CONSCIOUSNESS; ABC: AIRWAY, BREATHING,; CIRCULATION; Circulation; Respiration; PUPILLARY RESPONSES; Examine the Pupils and Their Responses; Pathophysiology of Pupillary Responses:; Peripheral Anatomy of the Pupillomotor System; Pharmacology of the Peripheral Pupillomotor System; Localizing Value of Abnormal Pupillary Responses in Patients in Coma; Metabolic and Pharmacologic Causes of Abnormal Pupillary Response; OCULOMOTOR RESPONSES; Functional Anatomy of the Peripheral Oculomotor System; Functional Anatomy of the Central Oculomotor System; The Ocular Motor Examination; Interpretation of Abnormal Ocular Movements; MOTOR RESPONSES; Motor Tone; Motor Reflexes; Motor Responses; FALSE LOCALIZING SIGNS IN PATIENTS WITH METABOLIC COMA; Respiratory Responses; Pupillary Responses; Ocular Motor Responses; Motor Responses; MAJOR LABORATORY DIAGNOSTIC AIDS; Blood and Urine Testing; Computed Tomography Imaging and Angiography; Magnetic Resonance Imaging and Angiography; Magnetic Resonance Spectroscopy; Neurosonography; Lumbar Puncture; Electroencephalography and Evoked Potentials; 3. Structural Causes of Stupor and Coma; COMPRESSIVE LESIONS AS A CAUSE OF COMA; COMPRESSIVE LESIONS MAY DIRECTLY DISTORT THE AROUSAL SYSTEM; Compression at Different Levels of the Central Nervous System Presents in Distinct Ways; The Role of Increased Intracranial Pressure in Coma; The Role of Vascular Factors and Cerebral Edema in Mass Lesions; HERNIATION SYNDROMES: INTRACRANIAL SHIFTS IN THE PATHOGENESIS OF COMA; Anatomy of the Intracranial Compartments; Patterns of Brain Shifts That Contribute to Coma; Clinical Findings in Uncal Herniation Syndrome; Clinical Findings in Central Herniation Syndrome; Clinical Findings in Dorsal Midbrain Syndrome; Safety of Lumbar Puncture in Comatose Patients; False Localizing Signs in the Diagnosis of Structural Coma; DESTRUCTIVE LESIONS AS A CAUSE OF COMA; DIFFUSE, BILATERAL CORTICAL DESTRUCTION; DESTRUCTIVE DISEASE OF THE DIENCEPHALON; DESTRUCTIVE LESIONS OF THE BRAINSTEM; 4. Specific Causes of Stupor and Coma; INTRODUCTION; SUPRATENTORIAL COMPRESSIVE LESIONS; EPIDURAL, DURAL, AND SUBDURAL MASSES; Epidural Hematoma; Subdural Hematoma; Epidural Abscess/Empyema; Dural and Subdural Tumors; SUBARACHNOID LESIONS; Subarachnoid Hemorrhage; Subarachnoid Tumors; Subarachnoid Infection; INTRACEREBRAL MASSES; Intracerebral Hemorrhage; Intracerebral Tumors; Brain Abscess and Granuloma; INFRATENTORIAL COMPRESSIVE ESIONS; EPIDURAL AND DURAL MASSES; Epidural Hematoma; Epidural Abscess; Dural and Epidural Tumors; SUBDURAL POSTERIOR FOSSA OMPRESSIVE LESIONS; Subdural Empyema; Subdural Tumors; SUBARACHNOID POSTERIOR FOSSA LESIONS; INTRAPARENCHYMAL POSTERIOR FOSSA MASS LESIONS; Cerebellar Hemorrhage; Cerebellar Infarction; Cerebellar Abscess; Cerebellar Tumor; Pontine Hemorrhage; SUPRATENTORIAL DESTRUCTIVE LESIONS CAUSING COMA; VASCULAR CAUSES OF SUPRATENTORIAL DESTRUCTIVE LESIONS; Carotid Ischemic Lesions; Distal Basilar Occlusion; Venous Sinus Thrombosis; Vasculitis; INFECTIONS AND INFLAMMATORY CAUSES OF SUPRATENTORIAL DESTRUCTIVE LESIONS; Viral Encephalitis; Acute Disseminated Encephalomyelitis; CONCUSSION AND OTHER TRAUMATIC BRAIN INJURIES; Mechanism of Brain Injury During Closed Head Trauma; Mechanism of Loss of Consciousness in Concussion; Delayed Encephalopathy After Head Injury; INFRATENTORIAL DESTRUCTIVE LESIONS; BRAINSTEM VASCULAR DESTRUCTIVE DISORDERS; Brainstem Hemorrhage; Basilar Migraine; Posterior Reversible Leukoencephalopathy Syndrome; INFRATENTORIAL INFLAMMATORY DISORDERS; INFRATENTORIAL TUMORS; CENTRAL PONTINE MYELINOLYSIS; 5. Metabolic and Diffuse Encephalopathies: Disruption of the Internal Milieu; DISTINGUISHING FEATURES OF METABOLIC ENCEPHALOPATHY; Mental status testing, delirium, and grading level of unresponsiveness; Distinguishing metabolic encephalopathy from focal causes of coma; Distinguishing metabolic encephalopathy from diffuse or multifocal causes of coma; Key features of the neurological exam in metabolic encephalopathy; THE INTERNAL MILIEU: AN OVERVIEW OF CEREBRAL METABOLISM AND THE ENVIRONMENT NECESSARY TO MAINTAIN NORMAL NEURONAL FUNCTION; Cerebral blood flow, glucose, and oxygen utilization; Acid-base balance and osmolality; Ionic environment in the brain and spreading depression; Synaptic environment in the brain and seizures; DISORDERS OF THE INTERNAL MILIEU: LACK OF SUBSTRATE; Cerebral hypoxia; Hypoperfusion (global ischemia, multifocal vascular compromise); Hypoglycemia; Lack of metabolic cofactors (thiamine); Mitochondrial disorders; DISORDERS OF THE INTERNAL MILIEU: IONIC AND OSMOTIC ENVIRONMENT; Hyponatremia; Hypernatremia; Hypercalcemia; Metabolic acidosis; Hyperglycemia, hyperosmolar state; Hypo-osmolar state; DISORDERS OF THE INTERNAL MILIEU: HORMONAL AND TEMPERATURE; Hypothyroidism; Hyperthyroidism; Adrenal insufficiency; Hypothermia; Hyperthermia; DISORDERS OF THE INTERNAL MILIEU: ELECTRICAL ENVIRONMENT; Seizure disorders; Spreading depression; DISORDERS OF THE INTERNAL MILIEU: ABNORMAL CSF PRESSURE OR CONSTITUENTS; Intracranial hypertension; Intracranial hypotension; Subarachnoid hemorrhage; Acute bacterial meningitis; Chronic bacterial or fungal meningitis; Viral meningitis vs. encephalitis; Carcinomatous meningitis; DISORDERS OF ENDOGENOUS TOXINS; Hypercarbia; Hepatic encephalopathy; Renal failure; Pancreatic encephalopathy; Systemic septic encephalopathy; Auto-immune disorders: specific antibodies; Auto-immune disorders: acute disseminated encephalomyelitis; DISORDERS OF EXOGENOUS TOXINS; Sedative/hypnotic drugs and anesthetics (GABA-A receptor enhancers); Ethanol, methanol, and propylene glycol (including withdrawal); Ketamine, phencyclidine (NMDA receptor antagonists); Antidepressants; Neuroleptics; Opiates; Aspirin and acetaminophen; Overdose of unknown type; 6. Psychogenic Unresponsiveness; CONVERSION REACTIONS; CATATONIA; PSYCHOGENIC SEIZURES; CEREBELLAR COGNITIVE AFFECTIVE SYNDROME; ’’AMYTAL INTERVIEW’’; 7. Approach to Management of the Unconscious Patient; A CLINICAL REGIMEN FOR DIAGNOSIS AND MANAGEMENT; ALGORITHM AND PRINCIPLES OF EMERGENCY MANAGEMENT; SUPPORT VITAL SIGNS: AIRWAY, BREATHING, AND CIRCULATION; Ensure Oxygenation, Airway, and Ventilation; Maintain the Circulation; HISTORY, EXAM, AND BASIC DIAGNOSTICS; Emergency Examination of the Comatose and Stuperous Patient; Emergent Treatment that Should be Considered for All Patients with Stupor or Coma; More Definitive Treatment of Etiologies of Stupor and Coma; 8. Management of Frequently Encountered Causes of Unconsciousness; MANAGEMENT OF FREQUENTLY ENCOUNTERED CAUSES OF UNCONSCIOUSNESS; STRUCTURAL LESIONS: SUPRATENTORIAL OR INFRATENTORIAL COMPRESSIVE/DESTRUCTIVE ETIOLOGIES; Aneurysmal Subarachnoid Hemorrhage; Intracerebral Hemorrhage; Traumatic Brain Injury; Subdural and Epidural Hematoma; Arterial Ischemic Stroke; Venous Sinus Thrombosis; Brain Tumor; Brain Abscess; NONSTRUCTURAL LESIONS: METABOLIC, DIFFUSE, OR MULTIFOCAL COMA; Central nervous system infections; Autoimmune causes of coma; Hypoxic Brain Injury / cardiac arrest; Metabolic coma; GENERAL MANAGEMENT CONSIDERATIONS APPLYING TO ALL OR MOST BRAIN INJURED PATIENTS; GOALS OF CARE; FINAL WORD; 9. Prognosis in Coma and Related Disorders of Consciousness and; Mechanisms Underlying Outcomes; 10. Brain Death - Joseph J. Fins; DETERMINATION OF BRAIN DEATH; CLINICAL SIGNS OF BRAIN DEATH; Brainstem Function; Confirmatory Laboratory Tests and Diagnosis; Diagnosis of Brain Death in Profound Anesthesia or Coma of Undetermined Etiology; Pitfalls in the Diagnosis of Brain Death; Brain Death versus Prolonged Coma; Management of the brain dead patient

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