Neurologic Emergencies [antikvár]

Neurologic emergencies are among the most sudden and explosive of all medical catastrophes. By definition, these disorders involve a variety of nervous structures often considered by both speciálist and nonspecialist alike to be of forbidding complexity. Nevertheless, the majority of patients with neurologic emergencies are first seen by emergency room physicians, internists, pediatricians, and neurologic housestaff. This book is for them, the front-line medical personnel, who diagnose, stabilize, and often salvage the patient before the arrival of the consultant. Neurologic emergencies are increasing in frequency and yet they may often go unrecognized. This book, the first restricted to the treatment of such disorders, takes the position that effective early management can be instituted in the absence of a specific diagnosis as long as somé determination has been made of the generál pathophysiologic mechanisms involved. Such a philosophy is in keeping with the practical nature of the volume and is highlighted by the liberal use of flow diagrams to outline specific steps in many of the diagnostic and treatment protocols. Whenever possible, aspects of the anatomy and physiology of the nervous system are reviewed in chapters devoted to the clinical situations for which they are most appropriate. Recent advances in neuroradiology, neuroanesthesiology, microneurosurgery, and medical neurology have revolutionized the treatment of elective neurologic patients over the past 10 years. The successful application of these techniques to emergency patients requires rapid and efficient initial management by frontline physicians who fully understand the unforgiving nature of the brain and spinal cord when faced with inadequate support. Quite often, simple transposition of the principles employed in the treatment of other medical and traumatic emergencies will salvage humán beings. It is necessary to abolish the sense of therapeutic nihilism with which neurologic emergencies are usually approached, an attitűdé which, in and of itself, is a barrier to eífective treatment. The text opens with a generál discussion of the pathophysiologic mechanisms involved in neurologic emergencies, the approach to the unconscious patient, and principles of cardiorespiratory management. Next, major sections are devoted to cerebrovascular and traumatic illnesses, the neurologic emergencies of greatest public impact. Certain special topics follow which have been deemed important based on the unique experience of the contributing authors gained at both a generál university hospitál and the contiguous Maryland Institute for Emergency Medical Services. This book is intended as an introduction to the subject and not as a substitute for the exhaustive nosologic approaches of conventional neurology texts. It is