By Sid M. Shah, Kevin M. Kelly
The editors of Emergency Neurology deliver their services to a instruction manual for the emergency division. The symptom-based emphasis courses the emergency doctor within the prognosis and administration of universal and intricate neurological problems. Integrating primary neurological thoughts with the calls for of emergency care, this reference device recommends short exam strategies. It offers severe details for emergency physicians diagnosing and handling neurologic issues similar to headache, seizure, and spinal wire damage.
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Extra info for Principles and Practice of Emergency Neurology: Handbook for Emergency Physicians
21. A. Midsagittal T1-weighted MRI showing abnormal hypointensity consistent with marrow infiltration by metastatic carcinoma in the L5 and T12 (arrowheads) vertebral bodies. Canal encroachment by an epidural mass is seen at the L5 level (arrow). B. T2weighted midsagittal MRI showing a lesion at L5 that has the unusual feature of disc space invasion (arrow). compress the spinal canal and/or spinal cord, occur more frequently than intrinsic cord lesions. 21). Phased array surface coil technology has facilitated metastatic survey of the entire spinal axis; sensitivity is similar to radionuclide bone scanning, and specificity is superior.
Bleeding following this procedure is normally mild and not of clinical consequence. The exception to this rule occurs in the setting of coagulopathy as previously discussed. 1. Lumbar puncture in an adult – left lateral decubitus fetal position. Post-LP headaches are fairly common but, in most cases, minor. The risk, severity, and longevity of such headaches appear to be more closely related to the size of the dural rent created than to any persistent leak of CSF, as has often been proposed. The headache can therefore be minimized by using as small gauge a needle as is feasible; 22-gauge is often recommended for its strength and ability to avoid deflection off the midline despite its small size.
Three-dimensional time-of-flight MRA centered on the circle of Willis. There is a saccular aneurysm (arrows) arising from the anterior communicating artery. A B its inherent soft tissue contrast characteristics and its multiplanar capability. 9). Traumatic brain injury resulting from shearing forces causes diffuse axonal injury. This can be better visualized on MRI than on CT. 10). Intracranial trauma can also precipitate cerebral infarction. For example, uncontrolled intracranial hypertension can lead to caudal herniation with compression of the posterior cerebral arteries.
Principles and Practice of Emergency Neurology: Handbook for Emergency Physicians by Sid M. Shah, Kevin M. Kelly