Review article
https://doi.org/10.26800/LV-145-supl1-33
Acute disturbance of consciousness
Marija Meštrović
; Klinika za dječje bolesti, Klinički bolnički centar Split
Edita Runjić
Abstract
Disturbances of consciousness in children can be caused by various disorders, from hypoglycemia to traumatic intracranial hemorrhages. The duration of periods of impaired consciousness varies from less than a minute, such as syncope, days and weeks, to a lifetime of disordered consciousness in certain patients, such as a minimally conscious state or a persistent vegetative state. A knowledge of neuroanatomy and its skilful application enables properly differentiating between these states and recognizing their causes. The ascending reticular activating system of the brainstem, the main pathway regulating wakefulness and sleep, lies in close proximity to
certain nuclei whose function can be clinically tested even in unconscious patients, allowing for localization of a potential focal lesion and assessment of damage. Neuroimaging, laboratory testing and electrophysiological studies can further identify different levels and causes of consciousness disorders. This paper aims to give a brief overview of the causes of disorders of consciousness, the pathophysiology of the damage they cause, the specifics of the clinical presentation that can be used to differentiate between them, and the basic principles of the diagnostic and therapeutic approach to a child with an acute disorder of the state of consciousness.
Keywords
CONSCIOUSNESS; COMA; ASCENDING RETICULAR ACTIVATING SYSTEM; PERSISTENT VEGETATIVE STATE; MINIMALLY CONSCIOUS STATE; BRAIN DEATH
Hrčak ID:
300860
URI
Publication date:
17.4.2023.
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