神经病学课件-华中科技大学课件

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1、FrequentlyoccurRapidlyassessAccuratediagnosisEffectivelymanageSeverepermanentsequelae(后遗症)Primary:initialstructuraldamageuponinjuryNeuronsSupportingtissuesBloodvesselsStemcelloffershopeSecondary:progressivecellulardysfunctionhypoxia,hypotension,seizures,hyper-thermia,etc.Treatmentsl

2、ightensecondaryinjuryAssoonaspossibleirreversibleTraditionalexaminationdoesn’twork.HistoryPEDDDiagnostictestsTreatmentParallelprocessesatdifferentlevelsofpatientmanagementarerequired.TreatmentPEDiagnostictestsDDHistoryAIRWAYBREATHINGCIRCULATIONNeurologicalstatusLevelofconsciousne

3、ssPupilsPatent(通畅的)CommoncausesVomitus(呕吐物)TongueobstructionProceduresCheckandclearmouth(suction,抽吸)Positioningintubation(插管)ProceduresCheckandclearmouthProceduresPositioning(head-tilt,chin-lift)ProceduresIntubationMonitoroxygensaturationSupplementaloxygenationECGHeartrate&cardiacrhyt

4、hmBloodpressureCompletebloodcountBloodglucoseElectrolyteBUN&CrThemostsensitiveindicatorDefinitions:Drowsiness(嗜睡)Stupor(昏睡)ComaConfusion(意识模糊)丘脑网状激活系统AVPUGCSPitfallsAlertVerbalStimulusResponsePainfulStimulusResponseUnresponsiveEyeopeningBestverbalresponseBestmotorresponseEYEOPENINGSpo

5、ntaneous4Tovoice3Topain2None1BESTVERBALRESPONSEOrientated(定向)5Confused4Inappropriate3Incomprehensible2None1BESTMOTORRESPONSEObeying6localizing5Withdrawing4Flexing(decorticate)3Extending(decerebrate)2None1Decorticate(去皮层)posturingDecerebrate(去大脑)posturingInterpretationMinor13-15Moderat

6、e9-12Severe3-8PersistentvegetativestateLocked-insyndromePsychomotorinhibition(e.g.flexibilitascerea蜡样屈曲)ComaIncreasedintracranialpressureMyastheniccrisisStroke/TIASeizure&statusepilepticusWithFocalsignsORMeningealirritationWithoutFocalsignsMeningealirritationCommonCauses－－Metabolicdis

7、turbances＋－StrokeTumorAbscess－/＋＋SAHMeningitisEncephalitisStructuraldisordersCTscan/MRICSFCommonCauses－－Metabolicdisturbances＋－StrokeTumorAbscess＋/－＋SAHMeningitisEncephalitisStructuraldisordersBloodglucoseCompletebloodcount&coagulationscreenElectrolyteBUN&CrLiverfunctiontests(esp.bloo

8、dammo