Author/Editor		Grad, A
Title		Izguba zavesti v nevrologiji
Translated title		Loss of consciousness in neurology
Type		članek
Source		In: Bručan A, Gričar M, editors. Urgentna medicina: izbrana poglavja 2. Zbornik 3. mednarodni simpozij o urgentni medicini; 1996 jun 26-29; Portorož. Ljubljana: Slovensko združenje za urgentno medicino,
Publication year		1996
Volume		str. 313-9
Language		eng
Abstract		Consciousness includes both arousal and awareness of the self and environment. Arousal is a function of the ascending activating system situated in the brainstem. Awareness is a function of diffusely situated integrative mechanisms in cerebral cortex. Loss of consciousness therefore results primarily from extensive damage to the cerebral hemispheres or from selective damage to the brainstem. The clinician confronted with unconscious patient is therefore faced with the classic problem of first localising the lesion and then determining the likely cause of coma. Causes of impaired consciousness are many, but only few of them are primarily neurologic. Causes due to primary brain injury or disease are associated with a demonstrable structural lesion: trauma, cerebrovascular disorders, infections, neoplasms and epilepsy. The following should be recorded from the neurologic examination: observation of the patient, level of unconsciousness, respiration pattern, position of the head and eyes, pupils, vestibulo-ocular reflex, motor response, and sensory system is tested by the reflex should be also tested. Besides routine laboratory screening computer tomography (CT) is mandatory in every patient where neurologic cause of unconsciousness is in question. Lumbar puncture should be done if there is a suspicion of intracranial infection. EEG is useful in metabolic encephalopathies, epilepsy, infection. There is no specific neurologic therapy. Therefore, an optimal general management is mandatory!
Descriptors		UNCONSCIOUSNESS NERVOUS SYSTEM DISEASES CONSCIOUSNESS DISORDERS COMA CONFUSION