Plum and posner’s diagnosis of stupor and coma fourth Edition series editor sid Gilman, md, frcp
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ASPECTS OF CEREBRAL METABOLISM PERTINENT TO COMA 198 CEREBRAL BLOOD FLOW 198 GLUCOSE METABOLISM 202 Hyperglycemia
Hypoglycemia ANESTHESIA 205 MECHANISMS OF IRREVERSIBLE ANOXIC-ISCHEMIC BRAIN DAMAGE 206 Global Ischemia
Focal Ischemia Hypoxia
EVALUATION OF NEUROTRANSMITTER CHANGES IN METABOLIC COMA 208 Acetylcholine
Dopamine Gamma-Aminobutyric Acid
Histamine
Glutamate Norepinephrine SPECIFIC CAUSES OF METABOLIC COMA 210 ISCHEMIA AND HYPOXIA 210 Acute, Diffuse (or Global) Hypoxia or Ischemia
Intermittent or Sustained Hypoxia
Sequelae of Hypoxia DISORDERS OF GLUCOSE OR COFACTOR AVAILABILITY 220 Hypoglycemia
Hyperglycemia Cofactor Deficiency DISEASES OF ORGAN SYSTEMS OTHER THAN BRAIN 224 Liver Disease
Renal Disease Pulmonary Disease
Pancreatic Encephalopathy
Diabetes Mellitus Adrenal Disorders
Thyroid
Disorders
Pituitary Disorders Cancer
EXOGENOUS INTOXICATIONS 240 Sedative and Psychotropic Drugs
Intoxication With Other Common Medications
Ethanol Intoxication Intoxication With Drugs of Abuse
Intoxication With Drugs Causing Metabolic Acidosis ABNORMALITIES OF IONIC OR ACID-BASE ENVIRONMENT OF THE CENTRAL NERVOUS SYSTEM 251 Hypo-osmolar States
Hyperosmolar States Calcium
Other
Electrolytes
Disorders of Systemic Acid-Base Balance DISORDERS OF THERMOREGULATION 259 Hypothermia
Hyperthermia INFECTIOUS DISORDERS OF THE CENTRAL NERVOUS SYSTEM: BACTERIAL 262 Acute Bacterial Leptomeningitis
Chronic Bacterial Meningitis INFECTIOUS DISORDERS OF THE CENTRAL NERVOUS SYSTEM: VIRAL 266 Overview of Viral Encephalitis
Acute Viral Encephalitis Acute Toxic Encephalopathy During Viral Encephalitis
Parainfectious Encephalitis (Acute Disseminated Encephalomyelitis)
Cerebral Biopsy for Diagnosis of Encephalitis xii
Contents CEREBRAL VASCULITIS AND OTHER VASCULOPATHIES 273 Granulomatous Central Nervous System Angiitis
Systemic Lupus Erythematosus
Subacute Diencephalic Angioencephalopathy Varicella-Zoster Vasculitis
Behc¸et’s Syndrome Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy MISCELLANEOUS NEURONAL AND GLIAL DISORDERS 276 Prion Diseases
Adrenoleukodystrophy (Schilder’s Disease) Marchiafava-Bignami Disease
Progressive Multifocal Leukoencephalopathy
Epilepsy
Mixed Metabolic Encephalopathy ACUTE DELIRIOUS STATES 282 Drug Withdrawal Delirium (Delirium Tremens)
Postoperative Delirium Intensive Care Unit Delirium
Drug-Induced Delirium 6. PSYCHOGENIC UNRESPONSIVENESS 297 CONVERSION REACTIONS 299 CATATONIA 302 PSYCHOGENIC SEIZURES 304 CEREBELLAR COGNITIVE AFFECTIVE SYNDROME 306 ‘‘AMYTAL INTERVIEW’’ 307 7. APPROACH TO MANAGEMENT OF THE UNCONSCIOUS PATIENT 309 A CLINICAL REGIMEN FOR DIAGNOSIS AND MANAGEMENT 309 PRINCIPLES OF EMERGENCY MANAGEMENT 311 Ensure Oxygenation, Airway, and Ventilation
Maintain the Circulation Measure
the Glucose
Lower the Intracranial Pressure Stop Seizures
Treat Infection Restore
Acid-Base Balance
Adjust Body Temperature Administer Specific Antidotes
Control
Agitation
Protect the Eyes EXAMINATION OF THE PATIENT 317 Verbal Responses
Respiratory Pattern Eye Opening
Pupillary Reactions
Spontaneous Eye Movement Oculocephalic Responses
Caloric
Vestibulo-Ocular Responses
Corneal Responses Motor Responses
Tendon
Reflexes
Skeletal Muscle Tone GUIDES TO SPECIFIC MANAGEMENT 320 Supratentorial Mass Lesions
Infratentorial Mass Lesions Metabolic Encephalopathy
Psychogenic Unresponsiveness A FINAL WORD 327 8. BRAIN DEATH 331 DETERMINATION OF BRAIN DEATH 331 CLINICAL SIGNS OF BRAIN DEATH 333 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 Contents
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