Unconsciousness and Altered States of Consciousness
Unconsciousness and altered states of consciousness are of important clinical significance due to their frequency and many and diverse possible causes. For graduation of altered states of consciousness, the following terms may be used: clouding of consciousness, delirium, stupor, and coma ###. The most important causes of unconsciousness or altered states of consciousness are quoted in Table 3.1, as far as they are important for the pediatric and other surgeons and marked according to their frequency of occurrence.
The Glasgow Coma Scale (GCS) has been developed for patients with head injury with the aim to obtain an objective and reproductive clinical tool for quantification of altered consciousness and determination of the degree of brain injury by its course. It became soon necessary to adapt the GCS for small children and infants (Table 3.2) and to apply it to the other disorders leading to impaired consciousness. In addition, the correct assignment of maximum 15 points may be hindered by additional abnormal findings such as eyelid swelling or paresis and therapeutic measures, for example, intubation and relaxation.
KeywordsHead Injury Glasgow Coma Scale Severe Head Injury Skull Fracture Conversion Disorder
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