Neuro-emergency

Increased intracranial

pressure

SOL

Trauma

SeizuresInfections

Encepha-lopathy

SEFALGIA

Increased ICP

Edema

– Interstitial

– Vascular

– Cytotoxic

Increased ICP

VentriclesBrain structureVascular

Increased ICP

Diagnosis

ASAP –

1 day

Proper treatment

Medical care

Drugs

Surgical

Monitor

Improvement

Complications

Prognosis

Coma

ARAS

Thalamus

Projectionfiber

Cortex

Brain infection

Bacterial meningitis

• LP

• Not doneproperly

• Vaccination

• Good vaccine

• Wrongpopulation

Tuberculous meningitis

• High TB incidence

• Death or severe neurologic complications

Encephalitis

• Viral: No treatment except HSV

• Autoimmune: Anti NMDA Encephalitis

• Super refractory status epilepticus

• Severe neurologic complications

Infratentorial

Supratentorial

Tentoriumcerebelli

SOL

Infratentorial Supratentorial

Hydrocephalus

ASAP or wait 5 minutes

Status epilepticus

Shorvon S, Ferlisi M. The treatment of super-refractory status epilepticus: A critical review of available therapies and a clinical treatment protocol. Brain. 2011;134:2802-18.

Stage 1: 30 min

Early SEStage 2: 30-120 min

Established SEStage 3: > 120 min

Refractory SE

10-15% of SE

After 24 hours

Super-refractory SE

Neuromuscular emergencies

• Most of doctors are unfamiliar with neuromuscular disease

• Some can cause life-threatening condition

• Myasthenia gravis

– Myasthenic crisis

– Cholinergic crisis

If we failed

Do not rescucitate

Brain death

Enjoy the workshop