The Diagnosis Of Stupor And Coma

Clifford B. Saper, Chair of Neurology at Harvard Medical School, and Nicholas D. Schiff of Weill Medical College in NY join the original authors to thoroughly update this seminal text with over 90% new material. the goal of the new edition is to provide a clinically slanted volume that will help the reader understand and diagnose severe brain dysfunction both as it exists and as it evolves in the seriously ill. the book remains a treatise on pathophysiology because recent imaging, electrophysiologic, and biochemical technologies (discussed in the book) are by themselves insufficient substitute

Plum and Posner's Diagnosis and Treatment of Stupor and Coma, 5th edition, is a major update of the classic work on diagnosing the cause of coma, with the addition of completely new sections on treatment of comatose patients, by Dr. Jan Claassen, the Director of the Neuro-ICU at Columbia New York Presbyterian Hospital. The first chapter of the book provides an up-to-date review on the brain mechanisms that maintain a conscious state in humans, and how lesions that damage these mechanisms cause loss of consciousness or coma. The second chapter reviews the neurological examination of the comatose patient, which provides the basis for determining whether the patient is suffering from a structural brain injury causing the coma, or from a metabolic disorder of consciousness. The third and fourth chapters review the pathophysiology of structural lesions causing coma, and the specific disease states that result in coma. Chapter five is a comprehensive treatment of the many causes of metabolic coma. Chapter 6 review psychiatric causes of unresponsiveness and how to identify and treat them. Chapters 7 and 8 review the overall emergency treatment of comatose patients, followed by the treatment of specific causes of coma. Chapter 9 examines the long term outcomes of coma, including the minimally conscious state and the persistent vegetative state, and how they can be distinguished, and their implications for eventual useful recovery. Chapter 10 reviews the topic of brain death and the standards for examination of a patient that are required to make the determination of brain death. The final chapter 11 is by J.J. Fins, a medical ethicist who was invited by the other authors to write an essay on the ethics of diagnosis and treatment of patients who, by definition, have no way to approve of or communicate about their wishes. While providing detailed background for neurological and neurosurgical specialists, the practical nature of the material in this book has found its greatest use among Internists, Emergency Medicine, and Intensive Care specialists, who deal with comatose patients frequently, but who may not have had extensive neurological training.

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. In addition, video clips on neurologic examination and neurologic manifestations seen in comatose patients can be found here: http://oxfordmedicine.com/comatosepatient2e. All video recordings from the first edition have been reformatted and remastered for optimal use, and several more video clips of patients have also been included.

Brain dysfunction is a major clinical problem in intensive care, with potentially debilitating long-term consequences for post-ICU patients of any age. The resulting extended length of stay in the ICU and post-discharge cognitive dysfunction are now recognized as major healthcare burdens. This comprehensive clinical text provides intensivists and neurologists with a practical review of the pathophysiology of brain dysfunction and a thorough account of the diagnostic and therapeutic options available. Initial sections review the epidemiology, outcomes, relevant behavioral neurology and biological mechanisms of brain dysfunction. Subsequent sections evaluate the available diagnostic options and preventative and therapeutic interventions, with a final section on clinical encephalopathy syndromes encountered in the ICU. Each chapter is rich in illustrations, with an executive summary and a helpful glossary of terms. Brain Disorders in Critical Illness is a seminal reference for all physicians and neuroscientists interested in the care and outcome of severely ill patients.

For more than 80 years this unique short atlas has been the go-to guide to the examination of patients with lesions of the peripheral nerves and nerve roots – appreciated by generations of students and experienced practitioners alike. First published in its original form in 1943 and updated in its sixth edition by highly respected author Michael O’Brien, this book is the perfect companion for all those involved or caring for patients with peripheral nerve injuries and other neuromuscular disorders. It covers mononeuropathies, peripheral nerve lesions, examination techniques and anatomy of the peripheral nervous system, all illustrated with excellent diagrams and high-quality photographs. Illustrated with exceptionally clear photographs, accompanied by simple anatomical diagrams to aid comprehension Useful tables of the innervation of muscles and the muscle and cutaneous distribution of peripheral nerves Updated to reflect latest changes in nomenclature New diagrams and illustrations, including of the spine and spinal nerve roots, male inguinal region and female perineum Summary table of the common compression and entrapment mononeuropathies, with sites now indicated on the nerve diagrams Access to the complete, enhanced eBook version – makes quick reference easier than ever for busy students and practitioners

The fifth edition of 'Plum and Posner's Diagnosis and Treatment of Stupor and Coma'provides a comprehensive overview of the theory behind regulation of consciousness in humans, the mechanisms of loss of consciousness clinically, and the examination and diagnosis of the cause of loss of consciousness in patients. New sections provide the latest information on the treatment of comatose patients, brain death, recovery from structural coma, and the ethics of dealing with comatose patients.