Anoxic brain injury physical examination: Difference between revisions
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{{Anoxic brain injury}} | {{Anoxic brain injury}} | ||
{{CMG}} | {{CMG}} | ||
==Overview== | |||
Physical examination involves a thorough neurologic evaluation, with a focus on the extent of involvement of the [[brainstem]]. | |||
==Physical Examination== | ==Physical Examination== | ||
Serial [[neurologic]] examinations are critical in the assessment of long term [[prognosis]]. | Serial [[neurologic]] examinations are critical in the assessment of long term [[prognosis]]. | ||
=== | ===Eyes=== | ||
The presence of peristently dilated [[pupil]]s is a poor [[prognosis|prognostic]] sign <ref>Steen-Hansen JE, Hansen NN, Vaagenes P, Schreiner B: Pupil size and light reactivity during cardiopulmonary resuscitation. A clinical study. Crit Care Med 1988;16:69-70.</ref>. It should be noted that both [[catecholamines]] and [[atropine]], can affect [[pupillary]] size, and confound the assessment of [[pupillary]] size. | |||
===Neurologic=== | |||
====Brainstem Assessment==== | ====Brainstem Assessment==== | ||
The [[brainstem]] is more resistant to [[hypoperfusion]] that the [[cerebral cortex]], and if the [[brainstem]] does not recover, the [[cerebral cortex]] is not likely to recover. The presence of [[brainstem]] [[reflex]]es is therefore critical to recovery. Preservation of [[brainstem]] function is indicated by the presence of [[blinking]], [[cough]]ing, [[gag reflex|gag]]ging, [[sneezing]], and [[yawning]]. | The [[brainstem]] is more resistant to [[hypoperfusion]] that the [[cerebral cortex]], and if the [[brainstem]] does not recover, the [[cerebral cortex]] is not likely to recover. The presence of [[brainstem]] [[reflex]]es is therefore critical to recovery. Preservation of [[brainstem]] function is indicated by the presence of [[blinking]], [[cough]]ing, [[gag reflex|gag]]ging, [[sneezing]], and [[yawning]]. | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
{{WH}} | |||
{{WS}} | |||
[[CME Category::Cardiology]] | |||
[[Category:Cardiology]] | [[Category:Cardiology]] | ||
[[Category:Neurology]] | [[Category:Neurology]] | ||
[[Category:Emergency medicine]] | [[Category:Emergency medicine]] | ||
[[Category:Needs content]] | [[Category:Needs content]] | ||
[[Category:Up-To-Date]] | [[Category:Up-To-Date]] | ||
[[Category:Up-To-Date cardiology]] | [[Category:Up-To-Date cardiology]] | ||
Latest revision as of 21:29, 14 March 2016
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Physical examination involves a thorough neurologic evaluation, with a focus on the extent of involvement of the brainstem.
Physical Examination
Serial neurologic examinations are critical in the assessment of long term prognosis.
Eyes
The presence of peristently dilated pupils is a poor prognostic sign [1]. It should be noted that both catecholamines and atropine, can affect pupillary size, and confound the assessment of pupillary size.
Neurologic
Brainstem Assessment
The brainstem is more resistant to hypoperfusion that the cerebral cortex, and if the brainstem does not recover, the cerebral cortex is not likely to recover. The presence of brainstem reflexes is therefore critical to recovery. Preservation of brainstem function is indicated by the presence of blinking, coughing, gagging, sneezing, and yawning.
References
- ↑ Steen-Hansen JE, Hansen NN, Vaagenes P, Schreiner B: Pupil size and light reactivity during cardiopulmonary resuscitation. A clinical study. Crit Care Med 1988;16:69-70.