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Metabolic Encephalopathy is meant to combine and correlate animal and human studies. It is hoped that increased awareness of the importance of early diagnosis and treatment of these disorders may result in a lowering of the incidence of structural changes and morbidity. These disorders hold a special fascination for both basic scientists and clinical investigators because they are accessible, treatable and there exists good animal models for study. Therefore, this book will pull together basic and clinical neuroscience issue in the treatment of specific metabolic encephalopathies.
Brain dysfunction is a major clinical problem in intensive care, with potentially debilitating long-term consequences for post-ICU patients of any age. The resulting extended length of stay in the ICU and post-discharge cognitive dysfunction are now recognized as major healthcare burdens. This comprehensive clinical text provides intensivists and neurologists with a practical review of the pathophysiology of brain dysfunction and a thorough account of the diagnostic and therapeutic options available. Initial sections review the epidemiology, outcomes, relevant behavioral neurology and biological mechanisms of brain dysfunction. Subsequent sections evaluate the available diagnostic options and preventative and therapeutic interventions, with a final section on clinical encephalopathy syndromes encountered in the ICU. Each chapter is rich in illustrations, with an executive summary and a helpful glossary of terms. Brain Disorders in Critical Illness is a seminal reference for all physicians and neuroscientists interested in the care and outcome of severely ill patients.
This open access book offers an essential overview of brain, head and neck, and spine imaging. Over the last few years, there have been considerable advances in this area, driven by both clinical and technological developments. Written by leading international experts and teachers, the chapters are disease-oriented and cover all relevant imaging modalities, with a focus on magnetic resonance imaging and computed tomography. The book also includes a synopsis of pediatric imaging. IDKD books are rewritten (not merely updated) every four years, which means they offer a comprehensive review of the state-of-the-art in imaging. The book is clearly structured and features learning objectives, abstracts, subheadings, tables and take-home points, supported by design elements to help readers navigate the text. It will particularly appeal to general radiologists, radiology residents, and interventional radiologists who want to update their diagnostic expertise, as well as clinicians from other specialties who are interested in imaging for their patient care.
In recent years, there has been rapid growth in knowledge pertaining to the nervous system. This has, in some measure, been due to the development and application of a number of techniques such as the 2-deoxyglucose method and microchemical methods for measuring metabolites and regional cerebral blood flow. Data from the application of these techniques are just beginning to be collected, and the next few years promise to bring many new and exciting findings. The study of energy metabolism in brain is particularly interesting due to the fact that although the brain has scant energy reserves (as compared with the liver), it has one of the highest metabolic rates in the body. Recent studies from several laboratories have shown a surprising divergence of re sponses to metabolic insult in different areas of brain. In this regard, the cer ebellum, for example, may have metabolic features which are uniqve from those of any other region. The high-energy phosphate compounds ATP and phos phocreatine, supplied by the oxidative metabolism of glucose, are necessary for normal cerebral functions such as the maintenance of membrane potentials, transmission of impulses, and synthetic processes. Interruption of substrate or "poisoning" of the system by a variety of means lead to a rapid change in cellular energetics, and ultimately cell death. From the clinical standpoint, an interesting feature of metabolic encephalopathy is that in many cases, early diagnosis and treatment may result in a rapid reversal of symptoms.
Plum and Posner's Diagnosis and Treatment of Stupor and Coma, 5th edition, is a major update of the classic work on diagnosing the cause of coma, with the addition of completely new sections on treatment of comatose patients, by Dr. Jan Claassen, the Director of the Neuro-ICU at Columbia New York Presbyterian Hospital. The first chapter of the book provides an up-to-date review on the brain mechanisms that maintain a conscious state in humans, and how lesions that damage these mechanisms cause loss of consciousness or coma. The second chapter reviews the neurological examination of the comatose patient, which provides the basis for determining whether the patient is suffering from a structural brain injury causing the coma, or from a metabolic disorder of consciousness. The third and fourth chapters review the pathophysiology of structural lesions causing coma, and the specific disease states that result in coma. Chapter five is a comprehensive treatment of the many causes of metabolic coma. Chapter 6 review psychiatric causes of unresponsiveness and how to identify and treat them. Chapters 7 and 8 review the overall emergency treatment of comatose patients, followed by the treatment of specific causes of coma. Chapter 9 examines the long term outcomes of coma, including the minimally conscious state and the persistent vegetative state, and how they can be distinguished, and their implications for eventual useful recovery. Chapter 10 reviews the topic of brain death and the standards for examination of a patient that are required to make the determination of brain death. The final chapter 11 is by J.J. Fins, a medical ethicist who was invited by the other authors to write an essay on the ethics of diagnosis and treatment of patients who, by definition, have no way to approve of or communicate about their wishes. While providing detailed background for neurological and neurosurgical specialists, the practical nature of the material in this book has found its greatest use among Internists, Emergency Medicine, and Intensive Care specialists, who deal with comatose patients frequently, but who may not have had extensive neurological training.
The leading reference on electroencephalography since 1982, Niedermeyer's Electroencephalography is now in its thoroughly updated Sixth Edition. An international group of experts provides comprehensive coverage of the neurophysiologic and technical aspects of EEG, evoked potentials, and magnetoencephalography, as well as the clinical applications of these studies in neonates, infants, children, adults, and older adults. This edition's new lead editor, Donald Schomer, MD, has updated the technical information and added a major new chapter on artifacts. Other highlights include complete coverage of EEG in the intensive care unit and new chapters on integrating other recording devices with EEG; transcranial electrical and magnetic stimulation; EEG/TMS in evaluation of cognitive and mood disorders; and sleep in premature infants, children and adolescents, and the elderly. A companion website includes fully searchable text and image bank.
The present book contains the Proceedings of a two day Symposium on Uremic Toxins organized at the University of Ghent in Belgium. A series of guest lectures, free communications and posters have been presented. An international audience of 163 scientists from 16 nationalities listened to and discussed extensively a spectrum of topics brought forward by colleagues and researchers who worked for many years in the field of Uremic Toxins. There is a striking contrast between all the new dialysis strategies available in the work to "clean" the uremic patients and the almost non-progression of our knowledge on uremic toxins in the past decade. In this sense the symposium was felt by all participants as a new start for the research in the biochemical field of the definition of uremia. If the present volume would stimulate new work in this field in order to define uremia, or identify the uremic toxins, the purpose of the organizers would be maximally fulfilled.
Encephalopathy and Nitrogen Metabolism in Liver Failure contains research reports and state-of-the-art reviews that were presented at the 11th International Symposium on Hepatic Encephalopathy and Nitrogen Metabolism in relation to liver disease, that was held in Amsterdam, The Netherlands from 30 May to 1 June, 2002. Themes covered include the metabolism of ammonia and amino acids in relation to liver disease, the assessment of hepatic encephalopathy (HE), minimal HE, animal models of HE, neuropsychiatric dysfunction in patients with chronic liver disease, the pathogenesis of HE, the astrocyte in liver disease, acute liver failure and cerebral edema, treatment of HE and artificial liver support systems. This volume provides an indispensable source of important new research findings and ideas for clinicians and biomedical scientists working in the field of HE and nitrogen metabolism in relation to liver disease.
Significantly revised and updated, the new second edition updates the science on neonatal encephalopathy presented in the 1st edition. The new 2nd edition recommends a broad evaluation of all potential contributing factors in every case of neonatal encephalopathy, including maternal medical history, obstetric and intrapartum factors, and placental pathology. This recommendation is a shift from the 2003 report, which focused on determining whether or not a hypoxic-ischemic event was the cause of neonatal encephalopathy. Includes new sections on - Placental pathology - Focal ischemic stroke - Neonatal interventions - Patient safety - Significant advances in neuroimaging This report will assist the clinician in evaluating a newborn with encephalopathy to assist in defining both the cause and timing.
This new bedside manual guides you through all the practical aspects of managing patients following cardiothoracic surgery and critically ill cardiology patients. Primarily designed to use in cardiothoracic intensive care units and coronary care units, it covers the perioperative management for the full range of cardiothoracic surgical procedures, the management of complications, and related issues. Core topics in cardiothoracic critical care, such as hemodynamic instability, arrhythmias, bleeding, and mechanical cardiac support, are afforded broad coverage. Also included are sections on advanced ventilatory techniques and veno-venous ECMO for treating severe respiratory failure, as well as nutritional support, treating and preventing infection, renal failure, and care of the dying patient. Concisely written and featuring liberal use of illustrations as well as an integrated, tightly edited style, and a limited number of key references, this volume will become your reference of choice for the care of of cardiothoracic surgery patients and critically ill cardiology patients. Find information quickly with concisely written text. Get a more complete picture with extensive illustrations. Focus on just the information you need using a a limited number of key references. Navigate the complexities of critical care for a fulll range of cardiothoracic surgery patients with in-depth coverage of perioperative care, management of complications, and more.