Neurology 4.12 Flashcards
What is a coma?
A state of profound unconsciousness from which one cannot be roused; may be due to the action of an ingested toxic substance or of one formed in the body, to trauma, or to disease
What are diffuse causes of a coma due to primary CNS etiologies?
- hydrocephalus [tumors, trauma]
- meningitis/encephalitis
- subarachnoid hemorrhage, stroke
- postictal (post-seizure)
What are examples of comas due to secondary systemic etiologies
- spesis/septic-shock (infection)
- hypoxia
- non-CNS organ failure [heart, kidney]
- edema
- metabolic
- drugs/toxins
What are focal causes of a coma due to primary CNS etiologies?
- brain tumors, infarcts, stroke, etc. in midbrain
- “ “ in brainstem
What is the likely etiology of pre-tibial edema?
hypothyroidism
What is dilerium?
A clouded state of consciousness and confusion, marked by difficulty in sustaining attention to stimuli, disordered thinking, defective perception (illusions and hallucinations), disordered sleep-wakefulness cycles, and motor disturbances.
What are the common causes of delirium?
- demnetia
- infection
- stroke
- head trauma
- hypoxia
- non-CNS organ failure
- hypoglycemia
What is the most common presentation of altered mental status in inpatient setting?
delirium; altered EEG
What are reversible causes of cognitive impairment?
- infection
- thyroid (vitamin B12)
- non-CNS organ failure
- metabolic
- drug/toxin
- hydrocephalus [get a CT to find tumor!!!]
What are the irreversible causes of cognitive impairment?
Alzheimer’s Disease (dementia)
Vascular (multiple stroke)
What is dementia?
memory loss; A general mental deterioration due to organic or psychological factors; characterized by disorientation, impaired memory, judgment, and intellect, and a shallow labile affect
Which diagnostic assesment is done for Alzheimer’s Disease?
mini-mental examination; send to neurologist if +
What is seen on a CT in Alzheimer’s Disease?
- increased CSF on CT
- atrophy of brain tissue
What is pseudodementia?
depression which presents like dementia in the elderly
What are the most important things to remember when making a differential diagnosis for dementia?
- does not fluctuate
- longer course
- attention is intact
- often overlap with delerium and depression in hospitalized patients
