Brain Herniation
Brain herniation is the displacement of part of the brain through an opening or across a separating structure into a region that it does not normally occupy.
Month January 2019
The Brainstem Rules of Four
OVERVIEW THE FOUR RULES In the rule of 4 there are 4 rules MEDIAL STRUCTURES The 4 medial structures and the associated deficits are: SIDE (i.e. LATERAL) STRUCTURES The 4 ‘side’ (lateral) structures and the associated deficits are: CRANIAL NERVES The 4 cranial nerves in…
Bulbar Dysfunction in ICU
Bulbar Dysfunction in ICU
Cerebral oedema
TYPES Cytotoxic edema Vasogenic edema CT FEATURES OF RAISED ICP References and Links
Delayed Awakening in ICU
Delayed Awakening in ICU
Examination of the unconscious patient
Coma is a state of unconsciousness caused by temporary or permanent impairment of the ascending reticular system in the brainstem, or both cerebral hemispheres.
Eye Movements in Coma
A simplified approach to spontaneous eye movements in coma
GBS vs CIP
OVERVIEW References and Links
Ranitidine
Ranitidine: H2 receptor antagonist; competitive blockade of H2 receptors -> decrease in secretion; also decreases action of gastrin and acetylcholine
Magnesium
Magnesium: electrolyte (second most abundant cation in intracellular fluid, after potassium); depresses neuronal activation; essential cofactor in >300 enzyme systems
Alfentanil
Alfentanil: synthetic mu-opioid receptor agonist analgesic drug. Analogue of the synthetic opioid fentanyl that is only 10% as potent (on a weight-to-weight basis), but has quicker onset, quicker time to maximal effect, shorter duration of action (10 minutes), is more cardiovascularly stable and has more respiratory depression
Alkali Therapies
Alkali Therapies: sodium bicarbonate; THAM; Carbicarb; Dichloroacetate; Dialysis / hemofiltration