Symptoms of hyponatremia differ in individuals depending on the severity. Most symptoms begin with lethargy even at mild levels. Individuals can often suffer from stomach aches, drowsiness, and vomiting. Admission to the hospital usually comes with severe symptoms such as lethargy, no orientation of time or place, and an altered state of conscious. After admittance to the hospital, routine bloodwork is completed in determining the initiating causes of these symptoms. If the results display sodium levels below the reference range of 135-145 mEq/L then patients are considered to be in a hyponatremic state (Pietrini 2010). These symptoms often worsen when treating with a hypertonic saline solution and in turn can initiate CPM development.
Patients begin to improve and become more alert after treatment of hyponatremia has begun. Neurological conditions often gradually improve. However, with treatment sodium levels return to normal while the patient reaches normatremia. At this time, development of more severe symptoms cause for further exanimation and testing. Symptoms of CPM have been seen 3-10 days after treatment of hyponatremia when patients reach normatremia. Restlessness and confusion are key symptoms in individuals who have recently undergone rapid treatment of hyponatremia. Lesions associated with CPM are believed to start developing when normatremia is reached too quickly.
Once patients reach normatremia, as discussed above, new symptoms develop and cause the need for a neurological examination to be performed. Upon completion of the examination, moderate quadriparesis, bilateral tremor, and limb dysmetria, which is the lack of coordination in muscle movement control, was seen. At the same time, an MRI may be performed and ...
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... the white matter of the brain. It is also important in determining pathological changes in early onset.
CT scans and DWI are important testing techniques used in determining initiating causes of neurological changes in individuals. However, currently the best testing method available in identifying CPM is by a magnetic resonance imaging (MRI) scan. With the use of strong magnetic fields and radiowaves in MRIs accurate body images are produced. MRI scans are highly sensitive and offer better visualizations of grey and white matter contrast in the brain. MRIs are the optimal choice for testing of diseases and/or disorders in the central nervous system. The most optimal time to perform an MRI is the most critical time to perform the scan as well, when patients develop neurological symptoms. Diagnosed is generally confirmed by autopsy results (Gheorghita et. al 2010).
The normal core temperature in adults ranges between 36.5°C and 37.5°C and hypothermia can be defined as core body temperature less than 36°C.(ref 1)
My interest in MRI started when I first read the book “MRI, The Basics” written by the author Ray Hashemi. By the time I successfully finished my MRI clinical placement in Tehran University of Medical Sciences, I knew for sure that MRI would be the field I would be choosing to take on. What attracts me most about MRI is how beautifully scientist could create a technology that can take advantage of the magnetic moments of human body for imaging it without any harms of ionizing radiation. Although there are drawbacks to MRI, combining it with other modalities would be a more effective approach to an accurate diagnosis.
The cause for the acid-base balance would be the sedative, the patient’s weight which is obese, respiratory, bicarbonate and metabolic problem.
Histological examination shows severe degeneration of Purkinje cells, reduction in the number of cells in the molecular and granular layers of the cerebellar cortex, severe loss of the number of cells in the pontine nuclei and olives, and demyelination of the middle cerebellar peduncle. The cerebellar nuclei are well preserved. The tegmentum of the pons, the corticospinal tracts, and the restiform body are also usually unaffected. In clinical cases involving extrapyramidal symptoms, degenerative changes in the striatum, espec...
Delirium in the Intensive Care Unit (ICU) has become a genuine phenomenon and can be problematic for the patient and the staff caring for them. Delirium occurs when a patient is placed in an unfamiliar environment and has to endure the stress of not just the hospitalization but the stimuli of the environment, which can cause disturbances in consciousness. Patients can become confused, anxious, and agitated; making this difficult for the staff to correctly diagnosis and care for them. Sleep deprivation and environmental factors along with neurotransmitters are strongly related to the occurrence of ICU delirium. ICU staff needs to become more educated on prevention, detection, and proper treatment for the patient experiencing this condition.
The specific brain regions affected by CTE are often debated, but some of the areas most commonly agreed upon to show deterioration are: limbic system (thalamus, hypothalamus, amygdala, mammillary bodies), hippocampus, cerebral cortex, fron...
Doctors need a sure way to diagnose the disease before treatment or studies can be done. The diagnosis is an autopsy of brain tissue examined under a microscope. In addition, medical history, a physical exam, and mental status tests are used for diagnosis (Posen, 1995). Often, tests are done to rule out other potential causes of the dementia. This allows the identification of other causes of thinking and behavioral changes to be made before concluding that the patient has Alzheimer’s or another form of dementia. The tests that are requested to be done include CT and MRI scans to rule out strokes or brain tumors which could account for change in memory and behavior; thyroid and psychological tests which can also detect thinking and behavior problems (Posen, 1995).
Walton, Sir John. Brain’s Diseases of the Nervous System. 9th ed. Oxford University Press. Oxford: 1985.
Based upon previous knowledge of brain function, what results from the testing were consistent with a brain injury?
Being hypothermic or having frostbite on any part of your body can be very dangerous. This is an interesting topic because it can happen to anyone at anytime and if your are not prepared for it, it can be life threatening. If you are just going out to play in the snow and you are not dressed warm enough or all your skin is not covered frostbite can develop and you are at risk of hypothermia. Even if it is not snowing and there is not a cloud in the sky you can develop hypothermia if it is cold enough. If you are going to go hiking or skiing you will want to be aware of what hypothermia is and what to do if you get frostbite as this can result in the amputation of limbs and fingers. When skiing up in Vermont over Christmas break while going down the mountain my fingers started hurting and they were very cold. My dad and I were going down to the base of mountain, it was our final run of the day. We were skiing in negative 20 degree weather. This sparked my interest in hypothermia and frostbite because if we had not decided to get off the mountain frostbite developed on my hands and fingers and I would have run the risk of maybe getting them amputated. The purpose of writing this paper is to show how dangerous and lethal hypothermia and frostbite are if not taken care of properly.
Patients in the Intensive Care Unit are at a high risk to develop delirium. It is one of the most common conditions encountered by the staff in an Intensive Care Unit. Delirium can be hyperactive or hypo active according to the patients’ behavior. Disorientation, agitation, hallucinations, or delusions are characteristics that may be observed in the patient with hyperactive delirium. Apathy, quietly confused, withdrawal, lethargy, and even total lack of responsiveness are all symptoms of hypoactive delirium. Some or all of these symptoms may occur at any time.
Ajay Kumar Goila and Mridula Pawar (2009). The Diagnosis of Brain Death. [ONLINE] Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2772257/. [Last Accessed 11 February 2014].
Since the brain is extremely fragile and difficult to access without risking further damage, imaging techniques are used frequently as a noninvasive method of visualizing the brain’s structure and activity. Today's technology provides many useful tools for studying the brain. But even with our highest technology out there we do not know everything definitely. We do have fallbacks at times and these fallbacks can lead to serious problems.
is characterized by “deterioration in the level of consciousness, with lethargy, decrease in arousal and headache. The timing of the development of cerebral edema is variable, within most cases occurring 4 to 12 hours after starting treatment. Several case reports showed the presence of cerebral edema before the initiation of therapy. A method of clinical diagnosis based on bedside evaluation of a neurological state in DKA have been developed” (Pandey).
Rationale: Early signs of dehydration include thirst and cessation of perspiration, muscle cramps, nausea and vomiting, lightheadedness, and orthostatic hypotension. Ackley and Ladwig p. 345