Neupsy Key

Before starting the assessment for brain death, reversible conditions or conditions that can interfere with the neurologic examination must be excluded. For example, hypothermia, hypotension, and metabolic disturbance that could…

Hypoxic-Ischemic Encephalopathy. Hypoxicischemic encephalopathy is the term used to describe such injury after cardiac arrest or severe hypoxia causing global injury, or prolonged hypotension causing arterial border zone injury. Many…

NEUROLOGIC EXAMINATION It is important to carry out careful physical and neurologic examinations. Evaluation of the patient’s spontaneous limb and bulbar movements, pupillary reactions, eye movements, and response to painful…

When a hemispheric lesion compresses the brainstem, the patient usually has signs or symptoms of hemisphere dysfunction, such as hemiparesis. Any space-occupying lesion, such as subdural hematoma, infarction, hemorrhage, or…

Coma Scales. The Glasgow Coma Scale score (see Section 14, Plate 14-15) for best motor response in either the upper or lower limbs is rated on a scale of 1…

Appropriate localizing and flexor responses in a comatose patient imply that sensory pathways are functioning and that the pyramidal tract from the cerebral cortex to effector is functioning at least…

The anatomic substrate for a disorder in consciousness is dysfunction in the reticular formation and the ascending reticular activating system (ARAS) because activation of the cerebral cortex during arousal and…

The thalamic perforating arteries may also hemorrhage. This often produces a thalamic syndrome similar to ischemic infarction. However, as the hemorrhage grows it may press downward on the midbrain, causing…

In addition, there are several cell groups along the midline and embedded in the internal medullary lamina (the intralaminar nuclei). These nuclei send projections more diffusely in the cerebral cortex,…

Patients with pituitary apoplexy present with severe headache of acute onset, which is typically considered as the worst headache ever experienced. Nausea and vomiting are very common. The rapid expansion…