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15 - Evaluation of the Comatose Patient and Overview of the Brain Death Examination

Published online by Cambridge University Press:  19 May 2022

By
Sherri A Braksick  and
Alejandro A Rabinstein
Edited by
Andrew M. Naidech
Andrew M. Naidech
Affiliation:
Northwestern University, Illinois
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Summary

An acutely comatose patient is a medical emergency that requires rapid evaluation and initiation of management of the underlying cause, whether it is due to a primary neurologic insult or secondary to a serious medical condition. Often, the most important details are obtained from a direct witness to the event that can provide information about the events leading up to the presentation and the patient’s medical history and medication usage. The physical examination provides clues to help localize the region of the central nervous system affected, helping to narrow the differential diagnosis. Diagnostic testing is tailored to the medical history and examination. Regardless of the ultimate cause, prompt initiation of treatment is imperative to provide the patient the best opportunity to recover. The diagnosis of brain death is a clinical diagnosis, and should be completed in a structured, stepwise manner. Ancillary testing should only be obtained if the clinical examination is unable to be fully completed.

Type
Chapter
Information
Neurocritical Care , pp. 295 - 317
Publisher: Cambridge University Press
Print publication year: 2022

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References

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