Outcome in patients with bacterial meningitis presenting with a minimal Glasgow Coma Scale score

Hyponatremia, most often in the elderly and caused by repeated vomiting, is another important cause for neurological manifestations. An MRI scan at Royal Hampshire County Hospital in Winchester, Hampshire, revealed she had meningitis and inflammation of the brain. Closed eyes Limbs do not respond, except for reflex movements There is no response to painful stimuli, except for reflex movements. Once they have treated open wounds and established proper breathing and blood flow to the brain, they evaluate a patient’s medical history to check for medications, conditions such as diabetes, and medical events such as strokes. The safety of steroid in critical illness has been explored here and here. Seizures and shock are treatable risk factors for a poor outcome at hospital discharge and at long-term follow-up visits. 273 and 275).

Connect to the full suite of AccessMedicine content and resources including more than 250 examination and procedural videos, patient safety modules, an extensive drug database, Q&A, Case Files, and more. “We reunite with souls at the time of death,” said Alexander, whose new book, “The Map of Heaven: How Science, Religion and Ordinary People Are Proving the Afterlife,” relates stories of others who have also had near-death experiences. Patients with negative CSF cultures, hospital-acquired meningitis, a neurosurgical device, or who underwent a neurosurgical operation within 1 month before bacterial meningitis onset were excluded. The grade II patient requires a light pain stimulus (such as a sharp pin tapped lightly over the chest wall) for appropriate arousal, or may be combative or belligerent. How are cluster headaches treated? The fatality was reported in Michigan. “Doctors warned us they did not know what the impact of the stress to his brain would be.

Obtaining additional history from friends, relatives, bystanders, and EMS personnel is essential. Drugs and alcohol. For Encephalitis, Aconitum Nap again is lead medicine. In patients with head injury the priority is to maintain adequate cerebral perfusion pressures and cerebral oxygenation. Electroencephalogram (EEG): may show high-amplitude low-frequency waves and triphasic waves but these findings are not specific for hepatic encephalopathy, although recent work suggests EEG may be useful prognostically.[6] MRI/CT scanning can help to exclude other causes of altered mental function such as intracranial lesions. Can cluster headaches be prevented? Other clues to the cause of coma may be available from the people who called for help.

The role of cerebrospinal fluid and the extent of MRI changes in predicting the outcome at three months for JE patients were also evaluated by χ2 test. Viral circulation most frequently begins in a rural cycle, being passed between birds (primarily wetland bird species) and bird-feeding mosquitoes. Heart attack may result a sudden cut-off of oxygen and blood flow to brain, known as hypoxia or anoxia. When the patient attempts to swallow, the effort can produce pharyngeal muscle spasms; sometimes even the thought of swallowing water or the sight of water can induce pharyngeal spasms. He’s a very popular integrative medical doctor and he’s done a lot of research on brain health. They also look for any physical signs that may give information about what caused the coma. Oxford, UK: Oxford University Press; 2007.

If the airway is obstructed, the obstruction should be cleared and the patient intubated. Her case, which made medical history, was recently described in the journal Neurology. Clinicopathological correlation and neurophysiological experimentation has shown that coma is caused by diffuse bilateral hemisphere damage, failure of the ascending reticular activating system, or both. Finally, the data were analyzed and the most common causes of loss of consciousness were determined. Continuous monitoring of mean arterial blood pressure and intracranial pressure in children with severe central nervous system infections will enable rapid diagnosis and initiation of treatment when cerebral perfusion pressure is reduced to critical levels. Patients: Consecutive children (n = 270) with acute nontraumatic coma between 2 months to 12 years. Myxoedema coma can be regarded as a form of decompensated hypothyroidism in which the adaptations of the body to untreated hypothyroidism fail to maintain homoeostasis and become overwhelmed by hypothermia, infection or other precipitating factors.

“They told me he had meningitis and again they said viral. Symptoms of the virus include a slight fever, rash, conjunctivitis, headaches, joint and muscle pain. Antiemetics: odansetron, metoclopramide. There were 43 (18.7%) deaths of which 44.2% were within 3 days of admission. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Some of them are focal processes—localized abnormalities that exist only in one part of the brain—others are diffuse processes that affect large parts of the brain. See our User Agreement and Privacy Policy.

See our User Agreement and Privacy Policy. The causes of non-traumatic coma are diverse ranging from neurological to systemic causes. Our aim is to investigate the early prediction and outcome of SE in stroke patients with nosocomial coma (NC).