III./12. Neurological emergencies
Róbert Debreczeni
Introduction
In addition to discussing topics uncovered by other chapters (disorders of consciousness, regulation of intracranial pressure, symptomatology and pathomechanism of raised intracranial pressure, etc.), the aim of this chapter is to summarize the general aspects of the management of patients presenting with disorders of consciousness, which is one of the most challenging situations for physicians. The acute care of cerebrovascular patients (majority of them have cerebral ischemia) is also discussed here, as this is the most common emergency in neurology.
Keywords: disorders of consciousness, brainstem reflexes, raised intracranial pressure, cerebral edema
Structure of the chapter
This chapter is divided into the following parts (learning time requirements are provided in the brackets):
III./12.1 General aspects of management of neurological emergencies (20 minutes)
III./12.2. Disorders of consciousness (1 hour)
III./12.3. General aspects of the management of patients with disorders of consciousness (2 hours)
III./12.4. Regulation of intracranial pressure under
physiologic circumstances and in space-occupying lesions (1 hour)
III./12.5. Symptoms of brain herniations, cerebral edema, treatment of raised intracranial pressure (2 hours)
III./12.6. General aspects of management of cerebrovascular emergencies (2 hours)
References
Consciousness and altered consciousness, Szirmai I, MD, PhD, DSc;
Kamondi A, MD, PhD Clin Neurosci 2006;59(1–2):17–28.
Hughes, R. A. C. Neurological emergencies, 4th edition. 2007, Blackwell Pub. ISBN: 0727917749
Plum and Posner's Diagnosis of Stupor and Coma, 4th edition, Oxford University Press, USA 2007 ISBN: 0195321316
Arányi Z, Kamondi A, Kovács T, Szirmai I. Investigation of neurological patients.
European Stroke Organisation (ESO) Executive Committee; ESO Writing Committee. Guidelines for management of ischaemic stroke and transient ischaemic attack. 2008. Cerebrovasc Dis 2008;
25:457-507.
