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Çocuklarda Akut Bilinç Değişikliğine Yaklaşım

Year 2006, Volume: 4 Issue: 3, 80 - 87, 01.09.2006

M.şükrü Paksu H.ali Taşdemir

Abstract

Bilinç; kişinin kendinin ve çevrenin farkında olması durumudur. Bilincin içeriği; dikkat, duyu, algılama, hafıza, yönetme ve yönelim olarak sıralanabilir. iki komponenti vardır. Birisi uyanıklık, diğeri farkında olmadır. Uyanıklık ile farkında olma arasındaki ilişki hiyerarşiktir. Farkında olma ancak uyanıklık ile mümkün iken farkında olma kaybolsa bile uyanık olunabilir 1 . Farkında olmanın etkilendiği durumlarda dikkat eksikliği, demans, konfüzyon ve deliryum görülür 2 . Konfüzyonda; dikkat bozulmuştur ancak mental testlerin yapılabilmesi için yeterli uyanıklık sağlanabilir. Deliryumda ise nöronal eksitabilte artmıştır ve konfüzyon tablosuna huzursuzluk, saldırganlık, halisünasyonlar ve otonom disfonksiyon aşırı terleme, taşikardi, hipotansiyon eklenir.

References

  • 1. Stevens RD, Bhardwaj A. Approach to the comatose patient. Crit Care Med 2006; 34:31-41.
  • 2. Berger JR. Clinical approach to stupor and coma. In: Bradley WG, Daroff RB, Fenichol GM, Jankovic (ed). Butterworsh & Heinemann. Philadelphia 2004:43-64.
  • 3. Parvizi J, Damasio AR. Neuroanatomical correlates of brainstem coma. Brain 2003;126:1524-36.
  • 4. Zeman A. Consciousness. Brain 2001; 124:1263-89.
  • 5. Bateman DE. Neurological assessment of coma. J Neurol Neurosurg Psychiatry 2001; 71:13-77.
  • 6. Tafldemir HA, Serdaro¤lu A, Aysun S. Çocuk Sa¤l›¤› ve Hastal›klar› Dergisi 1996; 39:157-61.
  • 7. Lohr A, Liberalesso PB, Luzzi GC, de Faria AC, Bugallo MJ, Santos ML. Acute coma in children: etiology, morbidity and mortality. Arq Neuropsiquiatr. 2003; 61:621-4 (abstract).
  • 8. Bansal A, Singhi SC, Singhi PD, Khandelwal N, Ramesh S. Non traumatic coma. Indian J Pediatr 2005; 72:467-73.
  • 9. Kirkham FJ. Non-traumatic coma in children. Arch Dis Child 2001; 85:303-12.
  • 10. Persistent vegetative state: report of the American Neurological Association Committee on Ethical Affairs. ANA Committee on Ethical Affairs. Ann Neurol 1993; 33:386-90.
  • 11. Giacino JT, Ashwal S, Childs N et al. The minimally conscious state: definition and diagnostic criteria. Neurology 2002; 58:349-53.
  • 12. Mesulam MM. Frontal cortex and behavior. Ann Neurol 1986; 19:320-5.
  • 13. Pollard AJ, Britto J, Nadel S, DeMunter C, Habibi P, Levin M. Emergency management of meningococcal disease. Arch Dis Child 1999; 80:290-6.
  • 14. Kelley SD, Saperston A. Coma. In: Stone C.K, Humphries R (eds). Current emergency diagnosis and treatement. 5th edition. 2004. p:159-66.
  • 15. Plum F, Posner JB. The diangosis of stupor and coma, 4 th ed. Philedelphia: Davis, 1995.
  • 16. Yu PL, Jin LM, Seaman H, Yang YJ, Tong HX. Fluid therapy of acute brain edema in children. Pediatr Neurol 2000; 22:298-301.
  • 17. Wright RR, Mathews KD. Hypertensive encephalopathy in childhood. J Child Neurol 1996; 11:193-6.
  • 18. Meyer PG, Orliaguet GA, Zerah M, et al. Emergency management of deeply comatose children with acute rupture of cerebral arteriovenous malformations. Can J Anaesth 2000; 47:758-66.
  • 19. Nadel S, Joarder R, Gibson M, et al. Emergency cranial computed tomography in the management of acute febrile encephalopathy in children. J Accid Emerg Med 1999; 16:403-6.
  • 20. Crawley J, Smith S, Kirkham F, Muthinji P, Waruiru C, Marsh K. Seizures and status epilepticus in childhood cerebral malaria. QJM 1996; 89:591-7.
  • 21. Kriel RL, Krach LE, Luxenberg MG, Jones-Saete C, Sanchez J. Outcome of severe anoxic/ischemic brain injury in children. Pediatr Neurol 1994; 10:207-12.
  • 22. Grimwood K, Anderson P, Anderson V, Tan L, Nolan T. Twelve years outcomes following bacterial meningitis: further evidence for persisting effects. Arch Dis Child 2000; 83:111-6.
  • 23. Lahat E, Barr J, Barkai G, Paret G, Brand N, Barzilai A. Long term neurological outcome of herpes encephalitis. Arch Dis Child 1999; 80:69-71.
  • 24. Weinberger HA, van der Woude R, Maier HC. Prognosis of cortical blindness following cardiac arrest in children. JAMA 1962; 179:126-9.
  • 25. Han BK, Towbin RB, De Courten-Myers G, McLaurin RL, Ball WS Jr. Reversal sign on CT: effect of anoxic/ischemic cerebral injury in children. AJR Am J Roentgenol 1990; 154:361-8.

Year 2006, Volume: 4 Issue: 3, 80 - 87, 01.09.2006

M.şükrü Paksu H.ali Taşdemir

Abstract

References

  • 1. Stevens RD, Bhardwaj A. Approach to the comatose patient. Crit Care Med 2006; 34:31-41.
  • 2. Berger JR. Clinical approach to stupor and coma. In: Bradley WG, Daroff RB, Fenichol GM, Jankovic (ed). Butterworsh & Heinemann. Philadelphia 2004:43-64.
  • 3. Parvizi J, Damasio AR. Neuroanatomical correlates of brainstem coma. Brain 2003;126:1524-36.
  • 4. Zeman A. Consciousness. Brain 2001; 124:1263-89.
  • 5. Bateman DE. Neurological assessment of coma. J Neurol Neurosurg Psychiatry 2001; 71:13-77.
  • 6. Tafldemir HA, Serdaro¤lu A, Aysun S. Çocuk Sa¤l›¤› ve Hastal›klar› Dergisi 1996; 39:157-61.
  • 7. Lohr A, Liberalesso PB, Luzzi GC, de Faria AC, Bugallo MJ, Santos ML. Acute coma in children: etiology, morbidity and mortality. Arq Neuropsiquiatr. 2003; 61:621-4 (abstract).
  • 8. Bansal A, Singhi SC, Singhi PD, Khandelwal N, Ramesh S. Non traumatic coma. Indian J Pediatr 2005; 72:467-73.
  • 9. Kirkham FJ. Non-traumatic coma in children. Arch Dis Child 2001; 85:303-12.
  • 10. Persistent vegetative state: report of the American Neurological Association Committee on Ethical Affairs. ANA Committee on Ethical Affairs. Ann Neurol 1993; 33:386-90.
  • 11. Giacino JT, Ashwal S, Childs N et al. The minimally conscious state: definition and diagnostic criteria. Neurology 2002; 58:349-53.
  • 12. Mesulam MM. Frontal cortex and behavior. Ann Neurol 1986; 19:320-5.
  • 13. Pollard AJ, Britto J, Nadel S, DeMunter C, Habibi P, Levin M. Emergency management of meningococcal disease. Arch Dis Child 1999; 80:290-6.
  • 14. Kelley SD, Saperston A. Coma. In: Stone C.K, Humphries R (eds). Current emergency diagnosis and treatement. 5th edition. 2004. p:159-66.
  • 15. Plum F, Posner JB. The diangosis of stupor and coma, 4 th ed. Philedelphia: Davis, 1995.
  • 16. Yu PL, Jin LM, Seaman H, Yang YJ, Tong HX. Fluid therapy of acute brain edema in children. Pediatr Neurol 2000; 22:298-301.
  • 17. Wright RR, Mathews KD. Hypertensive encephalopathy in childhood. J Child Neurol 1996; 11:193-6.
  • 18. Meyer PG, Orliaguet GA, Zerah M, et al. Emergency management of deeply comatose children with acute rupture of cerebral arteriovenous malformations. Can J Anaesth 2000; 47:758-66.
  • 19. Nadel S, Joarder R, Gibson M, et al. Emergency cranial computed tomography in the management of acute febrile encephalopathy in children. J Accid Emerg Med 1999; 16:403-6.
  • 20. Crawley J, Smith S, Kirkham F, Muthinji P, Waruiru C, Marsh K. Seizures and status epilepticus in childhood cerebral malaria. QJM 1996; 89:591-7.
  • 21. Kriel RL, Krach LE, Luxenberg MG, Jones-Saete C, Sanchez J. Outcome of severe anoxic/ischemic brain injury in children. Pediatr Neurol 1994; 10:207-12.
  • 22. Grimwood K, Anderson P, Anderson V, Tan L, Nolan T. Twelve years outcomes following bacterial meningitis: further evidence for persisting effects. Arch Dis Child 2000; 83:111-6.
  • 23. Lahat E, Barr J, Barkai G, Paret G, Brand N, Barzilai A. Long term neurological outcome of herpes encephalitis. Arch Dis Child 1999; 80:69-71.
  • 24. Weinberger HA, van der Woude R, Maier HC. Prognosis of cortical blindness following cardiac arrest in children. JAMA 1962; 179:126-9.
  • 25. Han BK, Towbin RB, De Courten-Myers G, McLaurin RL, Ball WS Jr. Reversal sign on CT: effect of anoxic/ischemic cerebral injury in children. AJR Am J Roentgenol 1990; 154:361-8.
There are 25 citations in total.

Details

Primary Language Turkish
Journal Section Collection
Authors

M.şükrü Paksu This is me

H.ali Taşdemir This is me

Publication Date September 1, 2006
Published in Issue Year 2006 Volume: 4 Issue: 3

Cite

APA Paksu, M., & Taşdemir, H. (2006). Çocuklarda Akut Bilinç Değişikliğine Yaklaşım. Güncel Pediatri, 4(3), 80-87.
AMA Paksu M, Taşdemir H. Çocuklarda Akut Bilinç Değişikliğine Yaklaşım. Güncel Pediatri. September 2006;4(3):80-87.
Chicago Paksu, M.şükrü, and H.ali Taşdemir. “Çocuklarda Akut Bilinç Değişikliğine Yaklaşım”. Güncel Pediatri 4, no. 3 (September 2006): 80-87.
EndNote Paksu M, Taşdemir H (September 1, 2006) Çocuklarda Akut Bilinç Değişikliğine Yaklaşım. Güncel Pediatri 4 3 80–87.
IEEE M. Paksu and H. Taşdemir, “Çocuklarda Akut Bilinç Değişikliğine Yaklaşım”, Güncel Pediatri, vol. 4, no. 3, pp. 80–87, 2006.
ISNAD Paksu, M.şükrü - Taşdemir, H.ali. “Çocuklarda Akut Bilinç Değişikliğine Yaklaşım”. Güncel Pediatri 4/3 (September 2006), 80-87.
JAMA Paksu M, Taşdemir H. Çocuklarda Akut Bilinç Değişikliğine Yaklaşım. Güncel Pediatri. 2006;4:80–87.
MLA Paksu, M.şükrü and H.ali Taşdemir. “Çocuklarda Akut Bilinç Değişikliğine Yaklaşım”. Güncel Pediatri, vol. 4, no. 3, 2006, pp. 80-87.
Vancouver Paksu M, Taşdemir H. Çocuklarda Akut Bilinç Değişikliğine Yaklaşım. Güncel Pediatri. 2006;4(3):80-7.