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Diagnostic methods

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Neurology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The most frequent neurological disorders ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object]
Neurol. examination ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
II. optic nerve ,[object Object],[object Object],[object Object]
Corneal reflex (V and VII) ,[object Object],[object Object]
Babinski reflex
Brisky :physiological pathological :brisky +pyramidal sign
CT ,[object Object]
62 yrs stroke at admission One day later 2 days later
Hemorrhagic transformation 11th Dec dysart+mild hemipar 21st December worsening 27th of December
Cerebral hemorrhages
Angiography
DSA angiography ,[object Object],[object Object],[object Object],[object Object],[object Object]
Angiography 2. ,[object Object],[object Object],[object Object],[object Object]
MR-angiography ,[object Object],[object Object],[object Object],[object Object]
US ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SPECT (Single Photon Emission Computer Tomography) ,[object Object],[object Object],[object Object],[object Object],[object Object]
PET (Positron Emission Computer Tomography) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
PET 2. ,[object Object],[object Object],[object Object],[object Object]
Stroke in the left MCA area MRI TCD CBF HMPAO-SPECT F-DG-PET Left MCA infarct
Lumbal punction ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CSF ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
EEG ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
EEG 2. methods ,[object Object],[object Object],[object Object],[object Object],[object Object]
EEG 3. ,[object Object],[object Object],[object Object],[object Object]
EEG 4. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Transcranial Magnetic Stimulation ,[object Object],[object Object],[object Object]
VEP ,[object Object],[object Object],[object Object],[object Object]
SEP ,[object Object],[object Object],[object Object]
BAEP ,[object Object],[object Object],[object Object],[object Object]
EMG ,[object Object],[object Object],[object Object],[object Object],[object Object]
ENG ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
MEG ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Other methods 1. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Others 2. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Others 3. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Hypnoid type of disturbance of consciousness Either brain stem or Diffuse cortical damage or both
[object Object],[object Object],[object Object]
Glasgow coma scale Eye opening 1-4 Motor response 1-6 Verbal response 1-5
1. Brainstem ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],5.Extracorporal factors bact. viral inf. drugs, poisons ,[object Object],[object Object],2.Trauma? Subcutan hem. Fract linear impres. epidural h. Subdural h.S SAH Commotion Contusion (SAH) ,[object Object],[object Object],[object Object],[object Object],[object Object],3. Dysequilibrium of homeostasis/metab. Supratentorial Infratentorial Causes of disturbances of unconsciousness
Hunt and Hess Classification(*1) of Subarachnoid Hemorrhage Grade Description Periop. mortality (%) *2 Prob of survival (%) *3 0 Unruptured aneurysm 1 Assympto-matic, or mild headacheor nuchal rigidity 0-5 90 2 CN palsy, moderate or severe headache or nuchal rigidity 2-10 75 3 Mild focal deficit, lethargy, or confusion 10-15 65 4 Stupor, moderate or severe hemiparesis, early decerebrate posturing 60-70 45 5 Coma, decerebrate posturing, moribund 70-100 5
Non-hypnoid types of disturbance of conscioussness ,[object Object],[object Object],[object Object],[object Object],[object Object]
Brain death ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Brain death 1. ,[object Object],[object Object],[object Object]
Exclusion ,[object Object],[object Object],[object Object],[object Object],[object Object]
Criteria ,[object Object],[object Object],[object Object]
No breath ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Diagnosis in stroke ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Heart ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],TEE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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Diagnostic methods

  • 1.
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  • 8. Brisky :physiological pathological :brisky +pyramidal sign
  • 9.
  • 10. 62 yrs stroke at admission One day later 2 days later
  • 11. Hemorrhagic transformation 11th Dec dysart+mild hemipar 21st December worsening 27th of December
  • 14.
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  • 16.
  • 17.
  • 18.
  • 19.
  • 20.
  • 21. Stroke in the left MCA area MRI TCD CBF HMPAO-SPECT F-DG-PET Left MCA infarct
  • 22.
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  • 34.
  • 35.
  • 36.
  • 37.
  • 38. Hypnoid type of disturbance of consciousness Either brain stem or Diffuse cortical damage or both
  • 39.
  • 40. Glasgow coma scale Eye opening 1-4 Motor response 1-6 Verbal response 1-5
  • 41.
  • 42. Hunt and Hess Classification(*1) of Subarachnoid Hemorrhage Grade Description Periop. mortality (%) *2 Prob of survival (%) *3 0 Unruptured aneurysm 1 Assympto-matic, or mild headacheor nuchal rigidity 0-5 90 2 CN palsy, moderate or severe headache or nuchal rigidity 2-10 75 3 Mild focal deficit, lethargy, or confusion 10-15 65 4 Stupor, moderate or severe hemiparesis, early decerebrate posturing 60-70 45 5 Coma, decerebrate posturing, moribund 70-100 5
  • 43.
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  • 49.