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The Comatose Patient, Second Edition, is a critical historical overview of the concepts of consciousness and unconsciousness, covering all aspects of coma within 100 detailed case vignettes. This comprehensive text includes principles of neurologic examination of comatose patients as well as instruction of the FOUR Score coma scale, and also discusses landmark legal cases and ethical problems. As the Chair of Division of Critical Care Neurology at Mayo Clinic, Dr. Wijdicks uses his extensive knowledge to discuss a new practical multistep approach to the diagnosis of the comatose patient. Additionally, this edition includes extensive coverage of the interpretation of neuroimaging and its role in daily practice and decision making, as well as management in the emergency room and ICU. Dr. Wijdicks details long-term supportive care and an appropriate approach to communication with family members about end-of-life decision making. In addition, video clips on neurologic examination and neurologic manifestations seen in comatose patients can be found here: http://oxfordmedicine.com/comatosepatient2e. All video recordings from the first edition have been reformatted and remastered for optimal use, and several more video clips of patients have also been included.
Caring for a loved one in a coma is a distressing time, full of many questions, and often, not as many answers. Guide to a Comatose Patient is a first-of-its-kind book that steps into the shoes of the neurologist, to show the perspective of the staff caring for their loved ones — what worries us, how we think and intervene, what we can and cannot predict, and what we know as a certainty. In our hospital ICUs, there are more than a dozen comatose patients at any given point of time. Causes of coma can range from drug-induced coma—in which medications are used to calm the patient and allow the ventilator to work properly—to coma due to intoxication and coma related to a brain injury. No matter the reason, it can be a distressing time for loved ones. Guide to a Comatose Patient is a helpful guide for any family member or loved one confronted with coma. Author Eelco F. M. Wijdicks, M.D., Ph.D., a leading neurologist and attending neurointensivist at Mayo Clinic, begins each chapter by sharing helpful anecdotes from a career spanning four decades, before diving into the answers to commonly asked questions, such as: · What are the causes of coma? · When will the patient wake up and recover? · When is no recovery expected? · When should we consider organ donation? · What are the rates of survival? While there are many books on families’ experiences with acute traumatic brain injury and coma, Dr. Wijdicks offers an unusually candid conversation that allows a peek inside the minds of the doctors caring for your loved one. Having had many experiences talking to families having to make difficult decisions at a very difficult time, Dr. Wijdicks’s message is hopeful while remaining grounded in reality—a reality in which facts must dictate actions. Guide to a Comatose Patient provides important information so that families better understand treatment options, but most importantly, the book offers an open dialogue and optimal transparency to help provide hope and healing through times of grief.
Clifford B. Saper, Chair of Neurology at Harvard Medical School, and Nicholas D. Schiff of Weill Medical College in NY join the original authors to thoroughly update this seminal text with over 90% new material. the goal of the new edition is to provide a clinically slanted volume that will help the reader understand and diagnose severe brain dysfunction both as it exists and as it evolves in the seriously ill. the book remains a treatise on pathophysiology because recent imaging, electrophysiologic, and biochemical technologies (discussed in the book) are by themselves insufficient substitute
Plum and Posner's Diagnosis and Treatment of Stupor and Coma, 5th edition provides a comprehensive overview of the theory behind regulation of consciousness in humans, the mechanisms of loss of consciousness clinically, and the examination and diagnosis of the cause of loss of consciousness in patients. New sections provide the latest information on the treatment of comatose patients, brain death, recovery from structural coma, and the ethics of dealing with comatose patients.
New edition, completely rewritten, with new chapters on endovascular surgery and mitochrondrial and ion channel disorders.
Unique case-based guide to generating diagnostic possibilities based on the patients' symptoms. Invaluable for psychiatrists and neurologists.
When Carl awakens from a coma after being attacked on a subway train, life around him feels unfamiliar, even strange. He arrives at his best friend's house without remembering how he got there; he seems to be having an affair with his secretary, which is pleasant but surprising. He starts to notice distortions in his experience, strange leaps in his perception of time. Is he truly reacting with the outside world, he wonders, or might he be terribly mistaken? So begins a dark psychological drama that raises questions about the the human psyche, dream versus reality, and the boundaries of consciousness. As Carl grapples with his predicament, Alex Garland - author of The Beach and the screenplay for 28 Days Later, plays with conventions and questions our assumptions about the way we exist in the world, even as it draws us into the unsettling and haunting book about a lost suitcase and a forgotten identity.
This comprehensive resource examines every aspect of coma, including r elated anatomy, physiology, neurochemistry and pharmacology, new diagn ostic and therapeutic approaches, and decision making--and presents a clear clinical and investigative approach to the syndromes of impaired consciousness. It's unqiue blending of neuroscience with sound clinic al practice and modern management strategies creates a text that's emi nently useful in daily practice, providing effective management strate gies that respect medical, legal and ethical principles. More than a s cholarly text, this title addresses the hottest topics in the field in cluding side effects of modern therapies, new techniques for clinical examination, new methods of management in the ICU and much more.
Core Topics in Neuroanesthesia and Neurointensive Care is an authoritative and practical clinical text that offers clear diagnostic and management guidance for a wide range of neuroanesthesia and neurocritical care problems. With coverage of every aspect of the discipline by outstanding world experts, this should be the first book to which practitioners turn for easily accessible and definitive advice. Initial sections cover relevant anatomy, physiology and pharmacology, intraoperative and critical care monitoring and neuroimaging. These are followed by detailed sections covering all aspects of neuroanesthesia and neurointensive care in both adult and pediatric patients. The final chapter discusses ethical and legal issues. Each chapter delivers a state-of-the art review of clinical practice, including outcome data when available. Enhanced throughout with numerous clinical photographs and line drawings, this practical and accessible text is key reading for trainee and consultant anesthetists and critical care specialists.
Whenever the legitimacy of a new or ethically contentious medical intervention is considered, a range of influences will determine whether the treatment becomes accepted as lawful medical treatment. The development and introduction of abortion, organ donation, gender reassignment, and non-therapeutic cosmetic surgery have, for example, all raised ethical, legal, and clinical issues. This book examines the various factors that legitimatise a medical procedure. Bringing together a range of internationally and nationally recognised academics from law, philosophy, medicine, health, economics, and sociology, the book explores the notion of a treatment, practice, or procedure being proper medical treatment, and considers the range of diverse factors which might influence the acceptance of a particular procedure as appropriate in the medical context. Contributors address such issues as clinical judgement and professional autonomy, the role of public interest, and the influence of resource allocation in decision-making. Chapter 6 of this book is freely available as a downloadable Open Access PDF at http://www.taylorfrancis.com under a Creative Commons Attribution-Non Commercial-No Derivatives (CC-BY-NC-ND) 3.0 license.