Impairment of Consciousness and Coma

Taylor, D.A.; Ashwal, Stephen

doi:10.1016/b978-1-4377-0435-8.00073-1

Cited by 4 publications

(7 citation statements)

References 226 publications

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“…No clinical difference between types 1 and 2 has been reported. Though the pathophysiology of delirium is poorly understood, delirium is more likely to involve both cerebral hemispheres than the hemisphere on one side or the brainstem alone [8]. Neuroimaging and neuropsychological studies have revealed generalized disruption of higher cortical functions in adults with delirious behavior [9].…”

Section: Discussionmentioning

confidence: 99%

Differences in the time course of splenial and white matter lesions in clinically mild encephalitis/encephalopathy with a reversible splenial lesion (MERS)

Takanashi¹,

Imamura²,

Hayakawa³

et al. 2010

Journal of the Neurological Sciences

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Section: Discussionmentioning

confidence: 99%

Differences in the time course of splenial and white matter lesions in clinically mild encephalitis/encephalopathy with a reversible splenial lesion (MERS)

Takanashi¹,

Imamura²,

Hayakawa³

et al. 2010

Journal of the Neurological Sciences

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“…Herniation Syndromes Brain tissue deforms intracranially and moves from higher to lower pressure when there is asymmetric, unilateral or generalized increased intracranial pressure [3]. This gives rise to the various herniation syndromes ( Table 3).…”

Section: Brainstem Functionmentioning

confidence: 99%

“…Neck rigidity is present in meningitis, tonsillar herniation or craniocervical trauma. The Kernig's and Brudzinski's signs are more reliable signs of meningeal irritation [3].…”

Section: Brainstem Functionmentioning

confidence: 99%

“…Impaired consciousness implies a significant alteration in the awareness of self and of the environment, with varying degrees of wakefulness [3]. Descriptive terms such as somnolence, stupor, obtundation, and lethargy used to denote different levels of wakefulness are best avoided, given the lack of uniformity in the way these states are defined in the literature.…”

Section: Definitions: Coma and Other States Of Impaired Consciousnessmentioning

confidence: 99%

“…Comatose patients have no eye opening. As opposed to states of transient unconsciousness such as syncope or concussion, coma must last for at least 1 h [3].…”

Section: Definitions: Coma and Other States Of Impaired Consciousnessmentioning

confidence: 99%

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Approach to the Child with Coma

et al. 2010

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Coma and other states of impaired consciousness represent a medical emergency. The potential causes are numerous, and the critical window for diagnosis and effective intervention is often short. The common causes of non-traumatic coma include central nervous system infections, metabolic encephalopathy (hepatic, uremic, diabetic ketoacidosis etc.), intracranial bleed, stroke and status epilepticus. The basic principles of management include 1) Rapid assessment and stabilization, 2) Focussed clinical evaluation to assess depth of coma, localization of lesion in the central nervous system and possible clues to etiology, and 3) Treatment including general and specific measures. Commonly associated problems such as raised intracranial pressure and seizures must be recognized and managed to prevent secondary neurologic injury.

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Full Outline of UnResponsiveness Score Versus Glasgow Coma Scale in Children With Nontraumatic Impairment of Consciousness

et al. 2014

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The study was designed to compare the Full Outline of UnResponsiveness score with Glasgow Coma Scale as a predictor of mortality and poor functional outcome at hospital discharge in children with nontraumatic impairment of consciousness. Seventy children aged 5 to 18 years admitted with impaired consciousness were enrolled. The scores were applied by the Pediatric Neurology fellow within 2 hours of admission. The primary outcome studied was in-hospital mortality. Receiver operating characteristic curves were used to compare the 2 scores. The area under the curves for Glasgow Coma Scale and Full Outline of UnResponsiveness scores were 0.916 and 0.940, respectively. However, the difference between the areas under curve for the 2 scores was not statistically significant (0.023; 95% confidence interval: -0.0115 to 0.058). Our data indicate that both the scores are good predictors for in-hospital mortality and functional outcome. However, no significant difference was observed between the ability of the 2 scores to predict the outcomes.

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Impairment of Consciousness and Coma

Cited by 4 publications

References 226 publications

Differences in the time course of splenial and white matter lesions in clinically mild encephalitis/encephalopathy with a reversible splenial lesion (MERS)

Differences in the time course of splenial and white matter lesions in clinically mild encephalitis/encephalopathy with a reversible splenial lesion (MERS)

Approach to the Child with Coma

Full Outline of UnResponsiveness Score Versus Glasgow Coma Scale in Children With Nontraumatic Impairment of Consciousness

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