昏迷plum分类（Coma plum classification）.docVIP

昏迷plum分类（Coma plum classification） Coma Plum classification Plum et al suggest that the pathological changes leading to coma may include 3 conditions: supratentorial and supratentorial lesions and metabolic disorders of the cerebral cortex. (I) supratentorial lesions In general, focal lesions of the cerebral hemisphere do not produce unconsciousness or coma, and are extensively damaged on both sides of the brain, and develop rapidly and can cause varying degrees of unconsciousness or coma. Such as extensive lesions, but slow progression of Alzheimer disease, symmetrical atrophy of the two hemispheres, clinical manifestations in addition to mental symptoms, there is no awareness of obstacles. Another side of the brain, such as cerebral hemisphere resection, does not occur consciousness barrier, but the acute side of the cerebral hemisphere, especially the dominant hemisphere of serious lesions, such as cerebral hemorrhage, can cause varying degrees of consciousness disorders. Space occupying lesions in the brain lead to tentorial herniation that oppresses or blocks the ascending reticular activating system, causing coma. In short, only the two hemispheres of extensive and rapid development, or on one side of the brain lesions grow down to incisural herniation shift extrusion nonspecific projection system takes place when a disturbance of consciousness or coma. (two) lesions under the screen The underlying lesion impairs or destroys the reticular formation of the brainstem, a nonspecific ascending projection system that produces severe Plum - conscious disturbances - coma. (three) diffuse lesions of the cerebral cortex A diffuse lesion of the bilateral cerebral hemisphere that progresses slowly and is not destroyed by its arousal activating system, so no coma, such as A1zhemers disease, occurs. But the bilateral cerebral hemisphere and severe acute diffuse lesions of the cerebral cortex, limbic cortex, thalamic reticular activating system nonspecific projection system