| |
| |
| |
| General Clinical Neurologic Problems in the Intensive Care Unit | |
| |
| |
| |
| Coma and Other States of Altered Awareness | |
| |
| |
| Definitions of Altered States of Consciousness | |
| |
| |
| Locked-in Syndrome | |
| |
| |
| Hypersomnia | |
| |
| |
| Acute Confusional State | |
| |
| |
| Coma | |
| |
| |
| Persistent Vegetative State | |
| |
| |
| Brain Death | |
| |
| |
| Neuroanatomy and Neuropharmacology of Consciousness | |
| |
| |
| Neurologic Examination of the Acutely Confused Patient | |
| |
| |
| Neurologic Examination of Comatose Patients | |
| |
| |
| Brain Herniation Syndromes | |
| |
| |
| Neurologic Examination in Brain Death | |
| |
| |
| Brain Stem Reflexes | |
| |
| |
| Motor Examination | |
| |
| |
| Apnea Test | |
| |
| |
| Neuroimaging in Coma | |
| |
| |
| Special Clinical Situations and Problems | |
| |
| |
| Failure to Awaken after Discontinuation of Sedation | |
| |
| |
| Failure to Awaken after Surgery | |
| |
| |
| Acute Loss of Consciousness in Evolving Critical Illness | |
| |
| |
| Approach to the Acutely Confused and Delirious Patient | |
| |
| |
| Approach to the Comatose Patient | |
| |
| |
| Approach to Brain Death | |
| |
| |
| Conclusions | |
| |
| |
| |
| Neurologic Manifestations of Pharmacologic Agents Commonly Used in the Intensive Care Unit | |
| |
| |
| Principles of Pharmacodynamics and Pharmacokinetics in Critical Illness | |
| |
| |
| Effect of Drugs on Neuromuscular Function | |
| |
| |
| Effect of Drugs on Level of Consciousness | |
| |
| |
| Narcotic Agents | |
| |
| |
| Midazolam | |
| |
| |
| Lorazepam | |
| |
| |
| Propofol | |
| |
| |
| Commonly Used Drugs with Direct Neurotoxic Effects | |
| |
| |
| Acute Steroid Myopathy | |
| |
| |
| Malignant Hyperthermia | |
| |
| |
| Neuroleptic Malignant Syndrome | |
| |
| |
| Lethal (Malignant) Catatonia | |
| |
| |
| Serotonin Syndrome | |
| |
| |
| Conclusions | |
| |
| |
| |
| Seizures in the Intensive Care Unit | |
| |
| |
| Generalized Tonic--Clonic Seizures | |
| |
| |
| Drug-Induced and Drug-Withdrawal Seizures | |
| |
| |
| Seizures and Acute Metabolic Derangements | |
| |
| |
| Seizures and Structural Central Nervous System Abnormalities | |
| |
| |
| Convulsive Status Epilepticus | |
| |
| |
| Laboratory Evaluation and Therapeutic Consequences | |
| |
| |
| Medical Complications | |
| |
| |
| Nonconvulsive Status Epilepticus | |
| |
| |
| Management of Seizures and Status Epilepticus | |
| |
| |
| Outcome | |
| |
| |
| Conclusions | |
| |
| |
| |
| Generalized Weakness in the Intensive Care Unit | |
| |
| |
| General Considerations | |
| |
| |
| Disorders of the Spinal Cord | |
| |
| |
| Disorders of Peripheral Nerves | |
| |
| |
| Disorders of the Neuromuscular Junction | |
| |
| |
| Disorders of skeletal muscle | |
| |
| |
| Electrodiagnostic Studies | |
| |
| |
| Conclusions | |
| |
| |
| |
| Neurologic Complications of Invasive Procedures in the Intensive Care Unit | |
| |
| |
| General Considerations | |
| |
| |
| Neurotoxicity of Radiologic Contrast Agents | |
| |
| |
| Cholesterol Embolization | |
| |
| |
| Air Embolism | |
| |
| |
| Neurologic Complications Associated with Specific Procedures | |
| |
| |
| Endotracheal Intubation | |
| |
| |
| Internal Jugular Vein Cannulation | |
| |
| |
| Arterial Cannulation | |
| |
| |
| Cardiac Catheterization | |
| |
| |
| Cardioversion | |
| |
| |
| Percutaneous Transluminal Coronary Angioplasty | |
| |
| |
| Visceral Angiography | |
| |
| |
| Intra-aortic Balloon Pump | |
| |
| |
| Ventricular Assist System | |
| |
| |
| Epidural Catheterization and Diagnostic Lumbar Puncture | |
| |
| |
| Miscellaneous Complications | |
| |
| |
| Conclusions | |
| |
| |
| |
| Neurologic Complications in Medical and Surgical Intensive Care Units and Transplantation Units | |
| |
| |
| |
| Neurologic Manifestations of Bacterial Infection and Sepsis | |
| |
| |
| Bacterial Meningitis | |
| |
| |
| Clinical Features | |
| |
| |
| Additional Studies | |
| |
| |
| Treatment | |
| |
| |
| Outcome | |
| |
| |
| Spinal Epidural Abscess | |
| |
| |
| Clinical Features | |
| |
| |
| Additional Studies | |
| |
| |
| Treatment | |
| |
| |
| Infective Endocarditis | |
| |
| |
| Clinical Features | |
| |
| |
| Initial Studies | |
| |
| |
| Management | |
| |
| |
| Infective Aneurysms | |
| |
| |
| Clostridial Syndromes | |
| |
| |
| Botulism | |
| |
| |
| Tetanus | |
| |
| |
| Sepsis | |
| |
| |
| Critical Illness Polyneuropathy | |
| |
| |
| Sepsis-Associated Encephalopathy | |
| |
| |
| Conclusions | |
| |
| |
| |
| Neurologic Complications of Cardiac Arrest | |
| |
| |
| General Considerations in Resuscitation Medicine | |
| |
| |
| Postresuscitation Encephalopathy | |
| |
| |
| Clinical Features | |
| |
| |
| Laboratory Investigations | |
| |
| |
| Treatment and Supportive Care | |
| |
| |
| Basic Management | |
| |
| |
| Intracranial Pressure Monitoring | |
| |
| |
| Specific Treatment | |
| |
| |
| Conclusions | |
| |
| |
| |
| Neurologic Manifestations of Acid-Base Derangements, Electrolyte Disorders, and Endocrine Crises | |
| |
| |
| Acid-Base Disorders | |
| |
| |
| Respiratory Acidosis | |
| |
| |
| Respiratory Alkalosis | |
| |
| |
| Metabolic Acidosis | |
| |
| |
| Metabolic Alkalosis | |
| |
| |
| Electrolyte Disorders | |
| |
| |
| Hyponatremia | |
| |
| |
| Hypernatremia | |
| |
| |
| Hypokalemia | |
| |
| |
| Hyperkalemia | |
| |
| |
| Hypophosphatemia | |
| |
| |
| Hyperphosphatemia | |
| |
| |
| Hypomagnesemia | |
| |
| |
| Hypermagnesemia | |
| |
| |
| Hypocalcemia | |
| |
| |
| Hypercalcemia | |
| |
| |
| Endocrine Emergencies | |
| |
| |
| Nonketotic Hyperosmolar State | |
| |
| |
| Diabetic Ketoacidotic Coma | |
| |
| |
| Hypoglycemia | |
| |
| |
| Thyroid Storm | |
| |
| |
| Hashimoto's Encephalopathy | |
| |
| |
| Myxedema Coma | |
| |
| |
| Adrenal Crisis | |
| |
| |
| Conclusions | |
| |
| |
| |
| Neurologic Complications of Acute Renal Disease | |
| |
| |
| Uremic Encephalopathy | |
| |
| |
| Clinical Features | |
| |
| |
| Laboratory Tests | |
| |
| |
| Treatment | |
| |
| |
| Dialysis Dysequilibrium Syndrome | |
| |
| |
| Clinical Features | |
| |
| |
| Treatment | |
| |
| |
| Hypertensive Encephalopathy | |
| |
| |
| Clinical Features | |
| |
| |
| Neuroimaging | |
| |
| |
| Treatment | |
| |
| |
| Neuromuscular Disorders | |
| |
| |
| Myopathy | |
| |
| |
| Polyneuropathy of Renal Disease | |
| |
| |
| Mononeuropathies | |
| |
| |
| Conclusions | |
| |
| |
| |
| Neurologic Manifestations of Acute Hepatic Failure | |
| |
| |
| General Considerations | |
| |
| |
| Hepatic Encephalopathy | |
| |
| |
| Clinical Features | |
| |
| |
| Pathogenesis | |
| |
| |
| Laboratory Tests | |
| |
| |
| Medical Management | |
| |
| |
| Management of Brain Edema | |
| |
| |
| Surgical Management and Bridging Devices | |
| |
| |
| Conclusions | |
| |
| |
| |
| Neurologic Complications Associated with Disorders of Thrombosis and Hemostasis | |
| |
| |
| Disseminated Intravascular Coagulation | |
| |
| |
| Cerebral Venous Thrombosis | |
| |
| |
| Ischemic and Hemorrhagic Strokes | |
| |
| |
| Treatment | |
| |
| |
| Thrombolysis and Anticoagulation | |
| |
| |
| Thrombolysis-Associated Cerebral Hemorrhage | |
| |
| |
| Anticoagulant Therapy | |
| |
| |
| Thrombotic Thrombocytopenic Purpura | |
| |
| |
| Clinical Features | |
| |
| |
| Laboratory Findings and Neuroimaging | |
| |
| |
| Treatment | |
| |
| |
| Conclusions | |
| |
| |
| |
| Neurologic Complications of Acute Vasculitic Syndromes | |
| |
| |
| General Considerations | |
| |
| |
| Polyarteritis Nodosa | |
| |
| |
| Clinical Features | |
| |
| |
| Peripheral Nervous System Involvement | |
| |
| |
| Central Nervous System Involvement | |
| |
| |
| Churg-Strauss Syndrome | |
| |
| |
| Clinical Features | |
| |
| |
| Peripheral Nervous System Involvement | |
| |
| |
| Central Nervous System Involvement | |
| |
| |
| Wegener's Granulomatosis | |
| |
| |
| Clinical Features | |
| |
| |
| Peripheral Nervous System Involvement | |
| |
| |
| Central Nervous System Involvement | |
| |
| |
| Drug-Induced Vasculitis | |
| |
| |
| Conclusions | |
| |
| |
| |
| Neurologic Complications in the Critically Ill Pregnant Patient | |
| |
| |
| Eclampsia | |
| |
| |
| Clinical Features | |
| |
| |
| Neuroimaging | |
| |
| |
| Management | |
| |
| |
| Hellp Syndrome | |
| |
| |
| Clinical Features | |
| |
| |
| Neuroimaging | |
| |
| |
| Management | |
| |
| |
| Amniotic Fluid Embolism | |
| |
| |
| Clinical Features | |
| |
| |
| Management | |
| |
| |
| Neurologic Complications of Tocolytic Agents | |
| |
| |
| Conclusions | |
| |
| |
| |
| Neurologic Complications of Aortic Surgery | |
| |
| |
| Vascular Anatomy of the Spinal Cord | |
| |
| |
| Scope of the Problem | |
| |
| |
| Neurologic Features of Spinal Cord Infarction | |
| |
| |
| Anterior Spinal Artery Syndrome | |
| |
| |
| Brown-Sequard Syndrome | |
| |
| |
| Central Cord Syndrome | |
| |
| |
| Diagnostic Evaluation of Spinal Cord Infarction | |
| |
| |
| Magnetic Resonance Imaging | |
| |
| |
| Monitoring Techniques | |
| |
| |
| Therapeutic Options | |
| |
| |
| Plexopathies | |
| |
| |
| Aortic Dissection | |
| |
| |
| Neurologic Manifestations | |
| |
| |
| Diagnosis and Management | |
| |
| |
| Conclusions | |
| |
| |
| |
| Neurologic Complications of Cardiac Surgery | |
| |
| |
| General Considerations | |
| |
| |
| Ischemic Stroke | |
| |
| |
| Predictive Factors | |
| |
| |
| Clinical Features | |
| |
| |
| Neuroimaging | |
| |
| |
| Management | |
| |
| |
| Neuropsychologic Impairment | |
| |
| |
| Retinal Damage | |
| |
| |
| Peripheral Nerve Damage | |
| |
| |
| Conclusions | |
| |
| |
| |
| Neurologic Complications of Acute Environmental Injuries | |
| |
| |
| Thermal Burns | |
| |
| |
| Burn Encephalopathy | |
| |
| |
| Central Nervous System Infections | |
| |
| |
| Peripheral Neuropathies | |
| |
| |
| Smoke Inhalation | |
| |
| |
| Carbon Monoxide | |
| |
| |
| Cyanide | |
| |
| |
| Electrical Burns | |
| |
| |
| Spinal Cord Damage | |
| |
| |
| Peripheral Neuropathy | |
| |
| |
| Central Nervous System Manifestations | |
| |
| |
| Lightning Injury | |
| |
| |
| Clinical Features | |
| |
| |
| Management | |
| |
| |
| Accidental Hypothermia | |
| |
| |
| Clinical Features | |
| |
| |
| Treatment and Outcome | |
| |
| |
| Heat Stroke | |
| |
| |
| Clinical Features | |
| |
| |
| Treatment and Outcome | |
| |
| |
| Near-Drowning | |
| |
| |
| Clinical Features | |
| |
| |
| Management and Outcome | |
| |
| |
| Conclusions | |
| |
| |
| |
| Neurologic Complications of Multisystem Trauma | |
| |
| |
| Clinical Spectrum of Head Injury | |
| |
| |
| Neuroradiologic Findings in Head Injury | |
| |
| |
| Diffuse Axonal Injury | |
| |
| |
| Traumatic Intracerebral Hematomas | |
| |
| |
| Subdural or Epidural Hematoma | |
| |
| |
| General Principles of Management | |
| |
| |
| Management of Increased Intracranial Pressure | |
| |
| |
| Management of Traumatic Intracranial Hematomas | |
| |
| |
| Epidural Hematoma | |
| |
| |
| Subdural Hematoma | |
| |
| |
| Intraparenchymal Hematoma | |
| |
| |
| Management of Traumatic Cerebral Aneurysm | |
| |
| |
| Trauma of Spine and Spinal Cord | |
| |
| |
| Cervical Spine Injuries | |
| |
| |
| Thoracolumbar Spine Injuries | |
| |
| |
| Sacral Fractures | |
| |
| |
| Acute Spinal Cord Injury | |
| |
| |
| Post-Traumatic Neuropathies Associated With Fractures | |
| |
| |
| Brachial Plexopathies | |
| |
| |
| Lumbosacral Plexus Injury | |
| |
| |
| Miscellaneous Isolated Neuropathies Associated with Fractures | |
| |
| |
| Fat Embolism Syndrome | |
| |
| |
| Conclusions | |
| |
| |
| |
| Neurologic Complications of Organ Transplantation | |
| |
| |
| General Considerations in Transplantation | |
| |
| |
| Kidney and Pancreas Transplantation | |
| |
| |
| Heart and Lung Transplantation | |
| |
| |
| Liver Transplantation | |
| |
| |
| Hematopoietic Stem Cell Transplantation | |
| |
| |
| Neurologic Complications in Transplantation | |
| |
| |
| Neurotoxicity of Immunosuppressive Agents | |
| |
| |
| Central Nervous System Infections | |
| |
| |
| Cerebrovascular Complications | |
| |
| |
| Seizures | |
| |
| |
| De Novo Central Nervous System Malignant Lesions | |
| |
| |
| Neuropathies | |
| |
| |
| Neurologic Complications of Graft-Versus-Host Disease | |
| |
| |
| Polymyositis | |
| |
| |
| Myasthenia Gravis | |
| |
| |
| Conclusions | |
| |
| |
| |
| Outcome in Central Nervous System Catastrophes | |
| |
| |
| |
| Outcome of Acute Injury to the Central Nervous System | |
| |
| |
| Description of Outcome Categories After Coma | |
| |
| |
| Outcome in Metabolic Encephalopathies | |
| |
| |
| Postresuscitation (Anoxic-Ischemic) Encephalopathy | |
| |
| |
| Uremic Encephalopathy | |
| |
| |
| Hepatic Encephalopathy | |
| |
| |
| Sepsis-Associated Encephalopathy | |
| |
| |
| Diabetic Comas | |
| |
| |
| Outcome in Stroke | |
| |
| |
| Intracerebral Hematoma | |
| |
| |
| Ischemic Stroke | |
| |
| |
| Outcome in Head Injury | |
| |
| |
| Outcome in Traumatic Spine Injury | |
| |
| |
| Conclusions | |
| |
| |
| |
| Withdrawing Life Support in the Intensive Care Unit: A Neurologist's Perspective | |
| |
| |
| General Considerations | |
| |
| |
| Legal Aspects of Withdrawal of Care | |
| |
| |
| Decisions in Withdrawal of Care | |
| |
| |
| Withdrawal of Care | |
| |
| |
| Withdrawal of Care in Special Neurologic Circumstances | |
| |
| |
| Conclusions | |
| |
| |
| Index | |