The Comatose Patient

The Comatose Patient, Second Edition, is a critical historical overview of the concepts of consciousness and unconsciousness, covering all aspects of coma within 100 detailed case vignettes. This comprehensive text includes principles of neurologic examination of comatose patients as well as instruction of the FOUR Score coma scale, and also discusses landmark legal cases and ethical problems. As the Chair of Division of Critical Care Neurology at Mayo Clinic, Dr. Wijdicks uses his extensive knowledge to discuss a new practical multistep approach to the diagnosis of the comatose patient. Additionally, this edition includes extensive coverage of the interpretation of neuroimaging and its role in daily practice and decision making, as well as management in the emergency room and ICU. Dr. Wijdicks details long-term supportive care and an appropriate approach to communication with family members about end-of-life decision making. Now 100 comprehensive clinical vignettes New video clips of salient features of examination for online version New sections on functional MRI, Electrophysiology, Neurorehabilitation, Coma in the Emergency department and intensive care units. Eelco F.M. Wijdicks, MD, PhD, FACP, Mayo Clinic, USA Professor of Neurology Mayo Clinic College of Medicine Chair, Division of Critical Care Neurology Consultant, Neurosciences Intensive Care Unit Saint Marys Hospital Mayo Clinic, Rochester, MN CONTENTS Preface to the Second edition Preface to the First edition Part I: Understanding, Diagnosing, and Care of Comatose States 1. A History of Coma: Evolution of Ideas 2. The Neuroscience of the Awake State 3. Neurological Examination of the Comatose Patient and Localization Principles 4. Prolonged Impaired Consciousness 5. Brain Death 6. Neuroimaging, Neurophysiology and Neuropathology 7. Clinical Diagnosis and Decisions 8. Medical Care of the Comatose Patient 9. Recovery and Rehabilitation 10. Law and Bioethics 11. Media and popular culture Part II: The Clinical Approach to the Comatose Patient in 100 Vignettes 12 Introduction to 100 Clinical Vignettes 13 Comatose and traumatic brain injury 14 Comatose and gunshot wound to the brain 15 Comatose and traumatic brainstem lesion 16 Comatose after shaken impact syndrome 17 Comatose and acute epidural hematoma 18 Comatose and acute subdural hematoma 19 Comatose after cerebral hematoma 20 Comatose and intraventricular hemorrhage 21 Comatose and pontine hemorrhage 22 Comatose and cerebellar hemorrhage 23 Comatose and aneurysmal subarachnoid hemorrhage 24 Comatose and cerebral venous thrombosis 25 Comatose and hemispheric stroke 26 Comatose and bihemispheric stroke 27 Comatose and basilar artery occlusion 28 Comatose and bacterial meningitis 29 Comatose and brain abscess 30 Comatose and empyema 31 Comatose and acute herpes simplex encephalitis 32 Comatose and H1N1 influenza 33 Comatose and rabies encephalitis 34 Comatose and mumps encephalitis 35 Comatose and acute necrotic encephalitis 36 Comatose and zoonotic disease 37 Comatose and neuroaspergillosis 38 Comatose and nocardiosis 39 Comatose and high-grade astrocytoma 40 Comatose and CNS lymphoma 41 Comatose and metastasis 42 Comatose and gliomatosis 43 Comatose and paraneoplastic limbic-encephalitis 44 Comatose and autoimmune encephalitis 45 Comatose and acute disseminated encephalomyelitis 46 Comatose and fulminant multiple sclerosis 47 Comatose and osmotic demyelination 48 Comatose and acute hydrocephalus 49 Comatose and CSF hypotension 50 Comatose and convulsive status epilepticus 51 Comatose and nonconvulsive status epilepticus 52 Comatose in the recovery room 53 Comatose after organ transplantation 54 Comatose after coronary artery bypass surgery 55 Comatose on ECMO 56 Comatose after brain biopsy and craniotomy 57 Comatose and epilepsy surgery 58 Comatose after cerebral angiogram 59 Comatose after clipping of a ruptured cerebral aneurysm 60 Comatose after endovascular treatment of ruptured cerebral aneurysm 61 Comatose and hypothermia 62 Comatose and CO inhalation 63 Comatose and heatstroke 64 Comatose and near drowning 65 Comatose after cardiopulmonary resuscitation 66 Comatose after therapeutic hypothermia 67 Comatose after near hanging 68 Comatose after fat embolism syndrome 69 Comatose and air embolism 70 Comatose after status asthmaticus 71 Comatose and acute uremia 72 Comatose and acute hypertensive crises 73 Comatose and fulminant hepatic failure 74 Comatose and chronic liver disease 75 Comatose and thyroid disease 76 Comatose and sepsis 77 Comatose and endocarditis 78 Comatose after aorta dissection 79 Comatose and hypoglycemia 80 Comatose and hyperglycemia 81 Comatose and hyponatremia 82 Comatose and hypernatremia 83 Comatose and hypercalcemic crises 84 Comatose and hypercapnia 85 Comatose and pituitary apoplexy 86 Comatose and systemic lupus erythematosus 87 Comatose and central nervous system vasculitis 88 Comatose and acute thrombocytopenia 89 Comatose and acute leukemia 90 Comatose and acute porphyria 91 Comatose and urea cycle disorder 92 Comatose and Wernicke-Korsakoff Syndrome 93 Comatose and MELAS 94 Comatose and premature newborn 95 Comatose and fulminant cerebral vasoconstriction 96 Comatose and puerperium 97 Comatose and chemotherapy toxicity 98 Comatose and intrathecal baclofen overdose 99 Comatose and cefepime toxicity 100 Comatose and acetaminophen overdose 101 Comatose and tricyclic antidepressant overdose 102 Comatose and SSRI overdose 103 Comatose and alcohol intoxication 104 Comatose and ethylene glycol ingestion 105 Comatose and salicylate overdose 106 Comatose and opioid overdose 107 Comatose and benzodiazepine overdose 108 Comatose and lithium toxicity 109 Comatose after a rave party 110 Comatose and rapid dementing illness 111 Comatose and malignant catatonia 112 Comatose and conversion disorder