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131822114STUDIJA
SLUCAJA, Decembar 2011, Kosovska Mitrovica

131823356rutinske
laboratorijske analize, Decembar 2011

137988174COMA,
DIFFERENTIAL DIAGNOSIS

131834126dopunske
analize, Decembar 2011

132064504pregled
endokrinologa

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COMA,
DIFFERENTIAL DIAGNOSIS

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Harrison's Manual of Medicine 17/e

Table 17-2:
Differential Diagnosis of Coma
Table
17-2

Diseases
that cause no focal or lateralizing neurologic signs, usually with normal
brainstem functions; CT scan and cellular content of the CSF are
normal

oIntoxications:
alcohol, sedative drugs, opiates, etc.
oMetabolic
disturbances: anoxia, hyponatremia,
hypernatremia,
hypercalcemia,
diabetic acidosis, nonketotichyperosmolar
hyperglycemia, hypoglycemia, uremia, hepatic coma, hypercarbia,
addisonian
crisis, hypo- and hyperthyroid states, profound nutritional
deficiency
oSevere systemic
infections: pneumonia, septicemia, typhoid fever, malaria,
Waterhouse-Friderichsen
syndrome
oShock from any
cause
oPostseizure
states, status epilepticus,
subclinical epilepsy
oHypertensive
encephalopathy, eclampsia
oSevere
hyperthermia, hypothermia
oConcussion

oAcute
hydrocephalus

Diseases
that cause meningeal
irritation with or without fever, and with an excess of WBCs or RBCs in the
CSF, usually without focal or lateralizing cerebral or brainstem signs; CT or
MRI shows no mass lesion

oSubarachnoid
hemorrhage from ruptured aneurysm, arteriovenous
malformation, trauma
oAcute
bacterial meningitis
oViral
encephalitis
oMiscellaneous:
Fat embolism, cholesterol embolism, carcinomatous
and lymphomatous
meningitis, etc.

Diseases that cause focal
brainstem or lateralizing cerebral signs, with or without changes in the CSF;
CT and MRI are abnormal

oHemispheral hemorrhage
(basal ganglionic, thalamic) or infarction
(large middle cerebral artery territory) with secondary brainstem
compression
oBrainstem infarction due to
basilar artery thrombosis or embolism
oBrain abscess, subdural
empyema
oEpidural and subdural
hemorrhage, brain contusion
oBrain tumor with
surrounding edema
oCerebellar and pontine
hemorrhage and infarction
oWidespread traumatic brain
injury
oMetabolic coma (see above)
with preexisting focal damage
oMiscellaneous: cortical
vein thrombosis, herpes simplex encephalitis, multiple cerebral emboli due to
bacterial endocarditis,
acute hemorrhagic leukoencephalitis,
acute disseminated (postinfectious)
encephalomyelitis, thrombotic thrombocytopenic purpura,
cerebral vasculitis,
gliomatosiscerebri,
pituitary apoplexy, intravascular lymphoma, etc

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