长期和慢性意识障碍的预后
Julia M Carlson1, David J Lin2,3
1Division of Neurocritical Care, Department of Neurology, University of North Carolina Hospital, University of North Carolina School of Medicine, Chapel Hill, North Carolina.
Seminars in neurology
|September 27, 2023
概括
患有长期意识障碍 (DOC) 的患者仍然可以在受伤后的几个月或几年内实现显著的功能恢复. 神经科医生应该继续参与这些患者的护理.
科学领域:
- 神经学 神经学
- 神经科学是一个神经科学.
- 康复医学 康复医学 康复医学
背景情况:
- 持续的意识障碍 (DOCs) 可以延长超过28天,恢复继续进入慢性阶段.
- 在DOC中,即使损伤后3个月 (非创伤) 和12个月 (创伤) 后,功能恢复也是可能的.
- 预后是多因素的,受DOC状态,病因和患者人口统计学的影响.
研究的目的:
- 审查长期意识障碍中功能恢复的潜力.
- 讨论影响预后的因素和新兴的诊断方式.
- 强调持续的神经学参与患者护理的重要性.
主要方法:
- 关于长期意识障碍的文献综述.
- 分析影响患者预后的因素.
- 讨论当前和研究预测工具.
- 评估改善功能恢复的治疗选择.
主要成果:
- 在长时间的DOC患者中,可能会有显著的功能增长和恢复.
- 恢复轨迹可以延伸到慢性时期 (3或12个月以上).
- 目前正在研究几种测试方式 (EEG,fMRI,ERP) 用于预后.
结论:
- 患有长期或慢性DOC的患者具有恢复意识和功能恢复的潜力.
- 经验丰富的预后神经科医生对于管理这些患者至关重要.
- 鉴于延迟恢复的可能性,持续监测和管理是必不可少的.
相关概念视频
Stages of General Anesthesia
489
Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
489
Classification of Illness
7.6K
The meaning of illness is individualized to each person who experiences an alteration in health. In contrast, disease is a medical term indicating a pathological change in the structure and function of the body or mind. It is a condition that has specific symptoms and boundaries.
An illness is a response to a disease in which the person's level of functioning is changed compared with a previous level. The general classification of illness includes acute and chronic.
Acute illness is severe...
An illness is a response to a disease in which the person's level of functioning is changed compared with a previous level. The general classification of illness includes acute and chronic.
Acute illness is severe...
7.6K
Long-term Depression
2.6K
Long-term depression, or LTD, is one of the ways by which synaptic plasticity—changes in the strength of chemical synapses—can occur in the brain. LTD is the process of synaptic weakening that occurs over time between pre and postsynaptic neuronal connections. The synaptic weakening of LTD works in opposition to synaptic strengthening by long-term potentiation (LTP) and together are the main mechanisms that underlie learning and memory.
Calcium Ion Concentration Mechanism
If over...
Calcium Ion Concentration Mechanism
If over...
2.6K
Long-term Potentiation
55.3K
Long-term potentiation, or LTP, is one of the ways by which synaptic plasticity—changes in the strength of chemical synapses—can occur in the brain. LTP is the process of synaptic strengthening that occurs over time between pre- and postsynaptic neuronal connections. The synaptic strengthening of LTP works in opposition to the synaptic weakening of long-term depression (LTD) and together are the main mechanisms that underlie learning and memory.
55.3K
Psychosis: Goals of Pharmacotherapy
158
Antipsychotic drugs are a crucial treatment method for acute and chronic psychoses, bipolar illness, and behavioral disorders. The selection of these drugs depends on several factors, including the state of the disease, clinical judgment, possible drug interactions, and the patient's sensitivity to adverse effects. In immediate scenarios, such as delirium and dementia, short-term treatment with low doses of high-potency typical or atypical agents can effectively manage symptom exacerbation.
158
Restorative Care
2.0K
Restorative care is provided once a patient has been discharged from a healthcare facility and requires additional services. The additional services include home care, rehabilitation programs, and extended care. Restorative care centers help the patient regain their previous level of functioning or acquire a new level of functioning due to the incapacitating effects of a disease or a disability. It aims to assist patients in enhancing their quality of life by encouraging independence,...
2.0K


