Altered mental status pathophysiology: Difference between revisions
No edit summary |
No edit summary |
||
| Line 7: | Line 7: | ||
==Pathophysiology== | ==Pathophysiology== | ||
Although the neural science behind alertness, wakefulness, and arousal are not fully known, the [[reticular formation]] is known to play a role in these.<ref name="Tindall90"/> The [[ascending reticular activating system]] is a postulated group of neural connections that receives sensory input and projects to the [[cerebral cortex]] through the [[midbrain]] and [[thalamus]] from the retucular formation.<ref name="Tindall90"/> Since this system is thought to modulate wakefulness and sleep, interference with it, such as injury, illness, or metabolic disturbances, could alter the level of consciousness.<ref name="Tindall90"/> | |||
Normally, stupor and coma are produced by interference with the [[brain stem]], such as can be caused by a [[lesion]] or indirect effects, such as [[brain herniation]].<ref name="Tindall90"/> Mass lesions in the brain stem normally cause coma due to their effects on the reticular formation.<ref name="Tindall901"> | |||
{{ | |||
cite book |quote=Mass lesions within the brainstem produce coma by virtue of direct effects on the reticular formation |author=Tindall SC |editor=Walker HK, Hall WD, Hurst JW |chapter= Level of consciousness |title= Clinical Methods: The History, Physical, and Laboratory Examinations | |||
|publisher=Butterworth Publishers |location=|year=1990 |pages= |isbn= |oclc= |doi= |accessdate=2008-07-04 |url= http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=cm&partid=380 | |||
}} | |||
</ref> Mass [[lesion]]s that occur [[supratentorial|above]] the [[tentorium cerebelli]] (pictured) normally do not significantly alter the level of consciousness unless they are very large or affect both [[cerebral hemisphere]]s.<ref name="Tindall90"/> | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 01:44, 25 February 2014
|
Altered mental status Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Altered mental status On the Web |
|
American Roentgen Ray Society Images of Altered mental status |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Pratik Bahekar, MBBS [2]
Overview
Pathophysiology
Although the neural science behind alertness, wakefulness, and arousal are not fully known, the reticular formation is known to play a role in these.[1] The ascending reticular activating system is a postulated group of neural connections that receives sensory input and projects to the cerebral cortex through the midbrain and thalamus from the retucular formation.[1] Since this system is thought to modulate wakefulness and sleep, interference with it, such as injury, illness, or metabolic disturbances, could alter the level of consciousness.[1]
Normally, stupor and coma are produced by interference with the brain stem, such as can be caused by a lesion or indirect effects, such as brain herniation.[1] Mass lesions in the brain stem normally cause coma due to their effects on the reticular formation.[2] Mass lesions that occur above the tentorium cerebelli (pictured) normally do not significantly alter the level of consciousness unless they are very large or affect both cerebral hemispheres.[1]
References
- ↑ 1.0 1.1 1.2 1.3 1.4
- ↑
Tindall SC (1990). "Level of consciousness". In Walker HK, Hall WD, Hurst JW. Clinical Methods: The History, Physical, and Laboratory Examinations. Butterworth Publishers. Retrieved 2008-07-04.
Mass lesions within the brainstem produce coma by virtue of direct effects on the reticular formation