Neurologic Emergencies, An Issue of Emergency Medicine Clinics of North America

Name: Neurologic Emergencies, An Issue of Emergency Medicine Clinics of North America
Brand: Elsevier
Price: 78.99 EUR
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Jonathan A. Edlow Michael K. Abraham(Autor*in)

Elsevier (Verlag)

1. Auflage

Erschienen am 15. Oktober 2016

100 Seiten

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Front Cover
Neurologic Emergencies
Copyright
Contributors
CONSULTING EDITOR
EDITORS
AUTHORS
Contents
Foreword: Neurologic Emergencies
Preface: Neurologic Emergencies-Making the Diagnosis and Treating the Life Threats
Headache in the Emergency Department: Avoiding Misdiagnosis of Dangerous Secondary Causes
A New Approach to the Diagnosis of Acute Dizziness in Adult Patients
Acute Nontraumatic Back Pain: Risk Stratification, Emergency Department Management, and Review of Serious Pathologies
Status Epilepticus: What's New?
Initial Diagnosis and Management of Coma
Acute Generalized Weakness
Transient Ischemic Attacks: Advances in Diagnosis and Management in the Emergency Department
Diagnosis of Acute Ischemic Stoke
Treatment of Acute Ischemic Stroke
Diagnosis and Management of Acute Intracerebral Hemorrhage
Subarachnoid Hemorrhage
Diagnosis and Treatment of Central Nervous System Infections in the Emergency Department
Diagnosis of Acute Neurologic Emergencies in Pregnant and Postpartum Women
Neuro-Ophthalmology in Emergency Medicine
EMERGENCY MEDICINE CLINICS OF NORTH AMERICA
FORTHCOMING ISSUES
February 2017
May 2017
August 2017
RECENT ISSUES
August 2016
May 2016
February 2016
CME Accreditation Page
PROGRAM OBJECTIVE
LEARNING OBJECTIVES
ACCREDITATION
DISCLOSURE OF CONFLICTS OF INTEREST
UNAPPROVED/OFF-LABEL USE DISCLOSURE
TO ENROLL
METHOD OF PARTICIPATION
CME INQUIRIES/SPECIAL NEEDS
Foreword: Neurologic Emergencies
Preface: Neurologic Emergencies-Making the Diagnosis and Treating the Life Threats
Headache in the Emergency Department
Key points
NATURE OF THE PROBLEM/DEFINITION
GENERAL APPROACH TO THE PATIENT WITH HEADACHE
HIGH-RISK CLINICAL SCENARIOS
Scenario 1: Headache + Sudden/Severe Onset
Scenario 2: Headache + Focal Neurologic Deficits and Altered Mental Status
Scenario 3: Headache + Human Immunodeficiency Virus or Other Immunocompromised State
Scenario 4: Headache + Advanced Age
Scenario 5: Headache + Pregnancy
Scenario 6: Headache + Coagulopathy
Scenario 7: Headache + Malignancy
Scenario 8: Headache + Fever
Scenario 9: Headache + Visual Deficits
Scenario 10: Headache + Loss of Consciousness
DANGEROUS CAUSES OF SECONDARY HEADACHE
Subarachnoid Hemorrhage
Carotid/Vertebral Artery Dissection
Giant Cell Arteritis
Cerebral Vein and Sinus Thrombosis
Idiopathic Intracranial Hypertension
Acute Angle Closure Glaucoma
Bacterial Meningitis
Preeclampsia
Pituitary Apoplexy
Carbon Monoxide Poisoning
REFERENCES
A New Approach to the Diagnosis of Acute Dizziness in Adult Patients
Key points
INTRODUCTION
DIFFERENTIAL DIAGNOSIS OF ACUTE DIZZINESS
ORIGIN OF THE SYMPTOM QUALITY APPROACH TO DIAGNOSING DIZZINESS
REASONS WHY THE SYMPTOM QUALITY APPROACH LACKS SCIENTIFIC VALIDITY
MISDIAGNOSIS OF PATIENTS WITH DIZZINESS AND RESOURCE UTILIZATION
A NEW PARADIGM TO DIAGNOSE PATIENTS WITH ACUTE DIZZINESS - ATTEST
ACUTE VESTIBULAR SYNDROME
TRIGGERED EPISODIC VESTIBULAR SYNDROME
SPONTANEOUS EPISODIC VESTIBULAR SYNDROME
PUTTING IT ALL TOGETHER - AN OVERARCHING ALGORITHM
SUMMARY
REFERENCES
Acute Nontraumatic Back Pain
Key points
INTRODUCTION
Scope of the Problem
Differential Diagnosis
RISK STRATIFICATION
DIAGNOSTIC EVALUATION
Biomarkers
Imaging
MANAGEMENT OF SIMPLE BACK PAIN
DIAGNOSIS AND EMERGENCY DEPARTMENT MANAGEMENT OF HIGH-RISK PATIENTS
Diagnosis of Serious Causes
Management
REVIEW OF SERIOUS ETIOLOGIES
Spinal Epidural Abscess
Metastatic Epidural Tumor
Spinal Epidural Hematoma
Giant Disk Herniation
SUMMARY
REFERENCES
Status Epilepticus
Key points
INTRODUCTION
PATHOPHYSIOLOGY
Physiologic Changes in Generalized Convulsive Status Epilepticus
Pharmacoresistance in Prolonged Seizures
Evaluation and Management
Airway management
History
Diagnostic testing
Management
Treatment of underlying conditions
First-line Agents
Benzodiazepines
Second-line Agents
Phenytoins
Valproic acid
Intubation
Third-line Agents (Second-line Adjuncts)
Levetiracetam
Lacosamide
Phenobarbital
Ketamine
Fourth-line Treatment
Midazolam infusion
Propofol infusion
Barbiturate infusion
Adjunctive therapies
MANAGEMENT OF SUBTLE STATUS EPILEPTICUS
FAILURES IN THE MANAGEMENT OF STATUS EPILEPTICUS
COMPLICATIONS
SUMMARY
REFERENCES
Initial Diagnosis and Management of Coma
Key points
INTRODUCTION
PATHOPHYSIOLOGY
CAUSES
STRUCTURAL CAUSES OF COMA
Tumors
Acute Hydrocephalus
Intracranial Hemorrhage
Spontaneous subarachnoid hemorrhage
Subdural hemorrhage
Epidural hemorrhage
Intraparenchymal hemorrhage
Vascular Occlusion
DIFFUSE NEURONAL DYSFUNCTION CAUSES OF COMA: METABOLIC
Respiratory Insufficiency
Dysthermia
Hypertension
Dysglycemia
Electrolyte Disorders
Infection
Thyroid Disorders
Renal Failure
Hepatic Failure
Hyperammonemia
Thiamine Deficiency
Nonconvulsive Status Epilepticus
DIFFUSE NEURONAL DYSFUNCTION CAUSES OF COMA: TOXINS
Sedative-Hypnotic Agents
Opioids
Dissociative Agents
Carbon Monoxide
Serotonin Syndrome and Neuroleptic Malignant Syndrome
Miscellaneous Toxins
Coma Mimics
INITIAL STABILIZATION
HISTORY
PHYSICAL EXAMINATION
VITAL SIGNS
Pulse
Blood Pressure
Respiratory Rate
Temperature
Physical Examination
Head, eyes, ears, nose, and throat
Head
Eyes
Ears
Throat
Skin
Bowel Sounds
The Toxidrome-Oriented Physical Examination
IMAGING AND LABORATORY TESTING
GRADING SYSTEMS
TREATMENT
SUMMARY
REFERENCES
Acute Generalized Weakness
Key points
INTRODUCTION
HISTORY
Onset
Description of Weakness
Comorbidities
Family History
Medications
PHYSICAL EXAMINATION
Motor Nervous System
Elements of the Motor Examination
Bulk
Tone
Assessment of muscle strength
Stretch reflexes
EMERGENCY DEPARTMENT MANAGEMENT
GUILLAIN-BARRÉ SYNDROME
MYASTHENIA GRAVIS
BOTULISM
FAMILIAL PERIODIC PARALYSES
POLIOMYELITIS
ORGANOPHOSPHATE AND CARBAMATE POISONING
TRANSVERSE MYELITIS
TICK PARALYSIS
AMYOTROPHIC LATERAL SCLEROSIS
REFERENCES
Transient Ischemic Attacks
Key points
INTRODUCTION
DEFINITION
EPIDEMIOLOGY
ETIOLOGY AND PATHOPHYSIOLOGY
DIAGNOSIS
History
Physical Examination
Laboratory Tests
Electrocardiogram and Cardiac Monitoring
Cardiac Echocardiography
Brain Imaging
Cervical Vessel Imaging
RISK STRATIFICATION
TREATMENT
Immediate Treatment
Anticoagulant Therapy
Antiplatelet Therapy
Carotid Endarterectomy and Carotid Stenting
Treatment of Risk Factors
DISPOSITION
REFERENCES
Diagnosis of Acute Ischemic Stoke
Key points
INTRODUCTION
Community Awareness and Education
PREHOSPITAL IDENTIFICATION AND DIAGNOSIS
Prehospital Identification of Stroke
Prehospital Assessment of Stroke Severity
EMERGENCY DEPARTMENT EVALUATION
Patient History
Physical Examination
Primary assessment
Secondary assessment
Diagnostic Tests
Neuroimaging
Computed tomography
MRI
DIAGNOSIS AND DISPOSITION
REFERENCES
Treatment of Acute Ischemic Stroke
Key points
INTRODUCTION
PATIENT EVALUATION OVERVIEW
EMERGENT AND SUPPORTIVE CARE
REPERFUSION WITH INTRAVENOUS THROMBOLYSIS
THE ISSUE OF INFORMED CONSENT AND INFORMED REFUSAL
SAFETY OF TISSUE PLASMINOGEN ACTIVATOR IN STROKE MIMICS
ALTERNATIVE AND EMERGING THROMBOLYTIC AGENTS
INTERVENTIONAL STROKE TREATMENT
TREATMENT OF POSTERIOR CIRCULATION STROKE
APPROACH TO ILL-DEFINED STROKE ONSET
TREATMENT OF MINOR, ISOLATED, AND IMPROVING SYMPTOMS
NEUROPROTECTION
SONOTHROMBOLYSIS
MANAGEMENT OF HEMORRHAGIC TRANSFORMATION AND TISSUE PLASMINOGEN ACTIVATOR-RELATED BLEEDING
MANAGEMENT OF CEREBRAL EDEMA
SECONDARY PREVENTION
SUMMARY
REFERENCES
Diagnosis and Management of Acute Intracerebral Hemorrhage
Key points
INTRODUCTION AND EPIDEMIOLOGY
PATHOPHYSIOLOGY
CLINICAL PRESENTATION AND DIAGNOSIS
Clinical Assessment
Blood Tests
Neuroimaging
Noncontrast computed tomography
Computed tomography angiography
MRI
Natural History and Clinical Evolution
ACUTE MANAGEMENT
Prehospital Care
Airway Protection
Blood Pressure Management
Hemostatic Treatment
Platelet function
Warfarin-associated coagulopathy
Heparin-associated coagulopathy
Direct oral anticoagulants
Recombinant tissue plasminogen activator-associated coagulopathy
Intracranial Pressure Management
Seizures and Antiepileptic Treatment
Blood Glucose Management
Temperature Management
Surgical Treatment
Intraventricular hemorrhage management
Surgical hematoma evacuation
Decompressive craniotomy with or without hematoma evacuation
Minimally invasive surgery
ADMISSION TO STROKE UNIT OR NEUROSCIENCE INTENSIVE CARE UNIT
PROGNOSIS PREDICTION
FUTURE PERSPECTIVES
REFERENCES
Subarachnoid Hemorrhage
Key points
INTRODUCTION
Causes and Incidence
Symptoms and Clinical Presentation
Clinical Decision Rules and Differential Diagnosis
Clinical Severity Grading Scales
DIAGNOSTIC EVALUATION
Neuroimaging
Lumbar Puncture
MANAGEMENT
Pharmacologic Treatments
Antiepileptic drugs
Nimodipine
Blood pressure management
Antifibrinolytics
Nonpharmacologic Treatments
Fever management
Surgical and Endovascular Treatments
External ventricular drainage
Microsurgical clipping versus endovascular coiling
COMPLICATIONS
Rebleeding
Cerebral Edema
Vasospasm and Cerebral Ischemia
SUMMARY
REFERENCES
Diagnosis and Treatment of Central Nervous System Infections in the Emergency Department
Key points
INTRODUCTION
MENINGITIS
Clinical Presentation
Diagnostic Workup
Treatment
Bacterial meningitis
Viral meningitis
Fungal meningitis
ENCEPHALITIS
Clinical Presentation
Diagnosis
Treatment
BRAIN ABSCESS
Clinical Presentation
Diagnosis
Treatment
SPECIAL SITUATIONS
The Febrile Neonate
The Elderly Patient
Patients with Exposure to Arthropod Vectors
Human Immunodeficiency Virus and Other Immunocompromised States
Cerebrospinal Fluid Shunt Infections
SUMMARY
REFERENCES
Diagnosis of Acute Neurologic Emergencies in Pregnant and Postpartum Women
Key points
INTRODUCTION
HEADACHE
ACUTE NEUROLOGIC SYMPTOMS AND DEFICITS
SEIZURES
INDIVIDUAL CONDITIONS
CEREBRAL VENOUS SINUS THROMBOSIS
REVERSIBLE CEREBRAL VASOCONSTRICTION SYNDROME
POSTERIOR REVERSIBLE ENCEPHALOPATHY SYNDROME
NEUROLOGIC COMPLICATIONS OF ECLAMPSIA
RARE CONDITIONS CAUSING ACUTE NEUROLOGIC SYMPTOMS IN PREGNANT AND POSTPARTUM WOMEN
NEUROIMAGING AND MULTIDISCIPLINARY COORDINATION OF CARE
SUMMARY
REFERENCES
Neuro-Ophthalmology in Emergency Medicine
Key points
INTRODUCTION
ANATOMY AND PHYSIOLOGY
CLINICAL FINDINGS/PHYSICAL EXAMINATION TECHNIQUES
Inspection of the Pupils and Pupillary Reactivity
Extraocular Movements
Vestibular-Ocular and Caloric Testing
Corneal Reflex
Visual Fields
Patients with Altered Mental Status or Coma
SPECIFIC CLINICAL ISSUES
Visual Loss
Visual Field Loss
Unequal Pupils - Anisocoria
Diplopia, Cranial Nerve Palsies
Ptosis
Nystagmus
Increased Intracranial Pressure
Coma and Altered Mental Status
Toxins
Seizures
Carotid Cavernous Fistula
Nutritional Deficiency
Myasthenia Gravis
Stroke
Functional Neuro-Ophthalmologic Problems
SUMMARY
ACKNOWLEDGMENTS
REFERENCES
FURTHER READINGS
Index

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