Neurologic Emergencies, An Issue of Emergency Medicine Clinics (Volume 27-1) (The Clinics: Internal Medicine, Volume 27-1)

Topics include: ''Practical guide to hypothermia for neuroprotection'', ''Safety of stroke thrombolysis in community practice'', ''Glycemic control and the injured brain'', ''Vertigo and dizziness in the ED'', ''Critical care transport of patients with neuroemergencies'', ''Primary headaches in the ER'', ''Meningitis and encephalitis'', and ''Management of TIAs in the 21st Century''. Cover......Page 1 Foreword......Page 2 Preface......Page 4 Focal complaints......Page 6 Language Difficulties......Page 8 Vision Difficulties......Page 10 Sensory......Page 11 Seizures......Page 12 Encephalopathy......Page 14 Brain Death......Page 15 Neck/back pain......Page 16 Generalized weakness......Page 17 Nonanatomic complaints......Page 18 References......Page 19 Indications for critical care transport of patients who have neurological emergencies......Page 22 Time is Brain......Page 23 Stroke Centers and Emergency Medical Service Diversion......Page 25 Supportive Care and the Transport Environment......Page 26 Use of End-Tidal CO2 Monitoring in the Transport of Patients Who Have Traumatic Brain Injury......Page 27 Expedited Initiation of Therapeutic Hypothermia During Transport......Page 28 Cost of Transportation......Page 29 References......Page 30 Clinical Nihilism in Neuroemergencies......Page 32 Does prognostic information affect life support decisions in intensive care units?......Page 33 Outcome prediction in neuroemergencies......Page 34 Does prognostication influence outcome?......Page 36 What are we trying to achieve with prognostication?......Page 38 References......Page 39 Acute severe dizziness......Page 43 Nystagmus in Acute Severe Dizziness Presentations......Page 45 Vascular Causes of Acute Severe Dizziness......Page 46 Management of Acute Severe Dizziness......Page 47 Positional Testing and Particle Repositioning......Page 48 Recurrent attacks of dizziness......Page 50 Misconceptions......Page 51 Summary......Page 52 References......Page 53 Initial emergency department evaluation of patients who have a transient ischemic attack......Page 55 Clinical risk scores......Page 56 MRI in transient ischemic attack......Page 59 Vascular imaging......Page 60 Echocardiography......Page 61 Inpatient vs. outpatient evaluation of transient ischemic attack......Page 62 Acute management of transient ischemic attack......Page 63 Anticoagulation......Page 64 Atrial Fibrillation......Page 65 Thienopyridines (clopidogrel, ticlopidine)......Page 66 Other stroke prevention strategies......Page 67 References......Page 69 Diagnosis and Management of the Primary Headache Disorders in the Emergency Department Setting......Page 74 Migraine......Page 75 Triptans......Page 76 Dihydroergotamine......Page 77 Nonsteroidal anti-inflammatory drugs......Page 78 Recurrence of Migraine After Emergency Department Discharge......Page 79 Frequent Emergency Department Migraine Visitors......Page 80 Cluster......Page 81 Primary Cough Headache......Page 83 New daily persistent headache......Page 84 References......Page 85 Epidemiology......Page 91 Signs and symptoms......Page 92 Treatment......Page 93 Epidemiology......Page 96 Outcomes......Page 97 Outcomes......Page 98 References......Page 99 Emergency Treatment of Status Epilepticus: Current Thinking......Page 103 New definition of status epilepticus......Page 104 Prehospital treatment of status epilepticus......Page 105 Emergency department treatment of status epilepticus......Page 109 Nonconvulsive status epilepticus in the emergency department......Page 111 Summary......Page 113 References......Page 114 Enhancing Community Delivery of Tissue Plasminogen Activator in Stroke Through Community-Academic Collaborative Clinical Knowledge Translation......Page 116 Theories of Behavioral Change......Page 117 Governmental and professional approval......Page 118 European Union......Page 120 Current use......Page 121 Barriers to Tissue Plasminogen Activator Use......Page 122 Education......Page 124 Improving awareness......Page 125 Enhancing self-efficacy......Page 126 Increasing outcome expectancy......Page 127 Audit/Feedback......Page 128 Champion Development......Page 129 Potential impact of knowledge translation success in stroke......Page 130 References......Page 131 Brief history of therapeutic hypothermia......Page 138 Contemporary clinical trials of postarrest hypothermia......Page 139 Depth of hypothermia......Page 140 Cooling methods......Page 141 Adverse events of induced hypothermia......Page 142 Current recommendations and guidelines for postarrest hypothermia......Page 143 The development of hypothermia protocols......Page 144 Training......Page 145 References......Page 146 Traumatic Brain Injury......Page 151 High Prevalence of Stroke and Cerebrovascular Disease......Page 152 Racial Differences in Stroke Mortality Rates......Page 153 Hyperglycemia in Stroke......Page 154 Hyperglycemia in Subarachnoid Hemorrhage......Page 155 Pathophysiology of hyperglycemic injury in critical illness......Page 156 Mechanisms of Hyperglycemia-Induced Brain Injury......Page 157 Coronary Artery Surgery......Page 158 Acute Myocardial Infarction......Page 159 Surgical Critical Care......Page 160 Acute ischemic stroke......Page 161 Comparison of Insulin Protocols......Page 162 Emergency Department-Initiated Insulin Protocol in Neurologic Emergencies......Page 163 References......Page 164