TY  - CHAP
M1  - Book, Section
TI  - The Neurocritical Care Airway
A1  - Kumar, Avinash B.
A1  - Seder, David B.
A2  - Lee, Kiwon
PY  - 2017
T2  - The NeuroICU Book, 2e
AB  - A  58-year-old  man  with  a  known  history  of  poorly  controlled  hypertension  is  evaluated  in  the  emergency  department  after  being  found  down  for  an  unknown  period  of  time.  He  has  left-sided  hemiparesis  and  neglect,  a  left  frontotemporal  scalp  contusion,  and  somnolence.  Because  the  patient  could  not  remember  the  onset  of  symptoms  and  the  mechanism  of  injury  is  uncertain,  a  rigid  cervical  collar  is  placed  by  emergency  medical  services  in  the  field.  Computed  tomography  (CT)  of  the  head  demonstrates  a  large  right  thalamic  intracerebral  hemorrhage  with  intraventricular  extension.  There  is  no  skull  fracture,  cervical  spine  injury,  or  gross  cervical  misalignment.  During  the  initial  evaluation,  he  is  interactive  and  able  to  communicate  verbally,  and  he  denies  cervical  tenderness  to  a  confrontational  examination.  Just  prior  to  his  transfer  to  the  intensive  care  unit  (ICU),  he  becomes  progressively  obtunded,  with  a  symmetrical  increase  in  bilateral  lower  extremity  tone.  His  respiratory  status  rapidly  declines;  he  is  now  making  grunting  noises  and  actively  using  his  accessory  muscles.  It  is  not  known  when  he  last  ate,  and  examination  of  the  oropharynx  reveals  a  blunted  gag  reflex  and  weak  cough.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/19
UR  - neurology.mhmedical.com/content.aspx?aid=1143957146
ER  -