Goldman-Cecil Medicine

Approach to Cerebrovascular Diseases

Definition The term cerebrovascular disease refers to a group of conditions in which the brain or spinal cord is injured by a vascular cause. The onset is generally abrupt, but it also can be insidious. Clinical manifestations depend on the…

Sleep Disorders

Definition Sleep is an active state of decreased responsiveness during which multiple vital functions occur to promote higher cognitive functioning and overall good health. During this physiologic state, the brain restores several metabolic processes, clears waste products, and furthers synaptic…

Coma, Disorders of Consciousness, and Brain Death

Disorders of consciousness and limited responsiveness ( Table 373-1 ) encompass a range of conditions, from mild encephalopathy or confusion to coma and brain death. Although not all causes of encephalopathy lead to poor outcomes, the rapid and comprehensive evaluation…

The Epilepsies

Definition A seizure is defined by transient focal or generalized signs or symptoms due to abnormal excessive or synchronous neuronal activity in the brain. Focal seizures, which originate within neuronal networks limited to one cerebral hemisphere, produce signs and symptoms…

Cognitive Impairment and Dementia

The Spectrum of Mild Cognitive Impairment to Dementia Definition Dementia is a cognitive disorder that leads to interference with daily functioning and results in loss of independence ( Table 371-1 ). Dementia can range in severity from mild, when a…

Regional Cerebral Dysfunction: Higher Mental Functions

Definition Higher mental function is at the core of what defines competent, independent individuals. Impairment of higher mental function can be broadly classified into four categories. Intellectual developmental disorder is a form of cognitive impairment that is present from infancy.…

Traumatic Brain Injury and Spinal Cord Injury

Acute Brain and Spinal Injury Epidemiology Traumatic brain injury and traumatic spinal cord injury are common preventable diseases. The majority of patients with traumatic brain and spinal cord injuries are young adult males. Hospitalization for traumatic brain injury is more…

Headaches and Other Head Pain

Definition Headache, which is a very common symptom, can be secondary to an underlying abnormality but is usually a primary headache disorder such as migraine headache, tension-type headache, cluster headache, and paroxysmal hemicrania. Epidemiology About 90% of all adults experience…

Approach to the Patient with Neurologic Disease

Introduction Neurologic symptoms and diseases are encountered in all spheres of clinical practice. Many symptoms of nervous system diseases are a part of everyday experience for healthy people, whether it be slips of the tongue, headache, numbness, muscle twitches, tremors,…