Comas Flashcards
Coma results from a disturbance in the function of what brainstem system?
Reticular activating system
Above what level does stroke occur?
Above the mid pons
Every patient in coma should receive what 3 things intravenously?
Dextrose, thiamine, and naloxone
What’s the antidote for benzo toxicity?
Flumazenil
What are some causes of a sudden onset of coma?
Brainstem stroke, subarachnoid hemorrhage
What is a cause of rapid progression of coma (starting with hemiparesis, hemisensory deficit, aphasia)?
Intracerebral hemorrhage
What are some causes of protracted course leading to coma?
Tumor, abscess, chronic subdural hematoma
What are some causes of coma preceded by confusional state or agitated delirium?
Meningitis, encephalitis
What type of fracture are the following signs of:?
- Raccoon eyes
- Battle sign (mastoid)
- Hemotympanum
- CSF rhinorrhea or otorrhea
Basilar skull fracture
Which coma posturing involves flexing arm at elbow and extending legs?
Decorticate
Where is the lesion if there is decorticate posturing?
Thalamus
Where is the lesion if there is decerebrate posturing?
Midbrain
“Midcel”
What’s the cause of coma if there is bilateral symmetric posturing?
Metabolic or structural
Where is the lesion if there is unilateral or asymmetric posturing?
Contralateral cerebral hemisphere or brainstem
Where is the lesion if there is no response to pain or occasionally some flexion at the knee (spinal reflex)?
Pontine or medullary
