Glasgow Coma Scale And The Renin-Angiotensin System

This poses a challenge for the neocortical view, but has the potential to be remedied. "It may be objected that, in ordinary language, it makes sense to say of someone that he is irreversibly comatose but still alive. This must be admitted. … Do we value "life" even if unconscious, or do we value life only as a vehicle for consciousness? Our attitude to the doctrine of the sanctity of life very much depends on our answer to this question." (Glover, The Philosophy of Death, pg. 349) Is this a life worth living just for the sake of it? Glover points out that it is dangerous to separate lives into "worth living" and "not worth living", however, it appears as though society has reached a point at which this very distinction is being made in certain cases. Cases for euthanasia argue that an individual's suffering is capable of escalating to the point that death would be preferable over further pain and/or deterioration; examples include individuals who suffer severely from ALS, Huntington's Disease, various forms of cancer, etc. Although an individual who has experience neocortical brain death does not feel constant pain as a direct consequence of upper brain death, the process of sustaining the body is incredibly harsh and painful. This pain increases exponentially if said patient has opted to forgo any extraordinary measures and must be left to die of their own accord. Even with medical intervention the patient is at increased risk of contractors (which cause the hands and feet to curl and lose function), tissue breakdown, bed sores, sepsis, shock, bloodlust and many other afflictions that would eventually lead to death. For this reason, it seems clear that the value of being alive is not worth allowing the persistence of unconscious and, consequentially, a painful

1-Mr. Franklin had dizziness and was found on the floor. From his history, we know that two years ago he had a thrombotic cerebrovascular accident. The thrombotic cerebrovascular accident is unexpected death of some brain cells because of lack of oxygen when the blood supply to the brain is blocked by blood clots. This is also called stroke or CVA. This traumatic brain injury is related to blood vessel damage. Seizures and dizziness are some of the physical symptoms. We can rule out traumatic brain injuries like fluid buildup in the brain that could cause the brain to swell; skull fractures or wounds that can tear the meninges pooling blood outside the vessels and enabling the bacteria to infect the nervous system.

The Glasgow coma scale is the scoring system that monitors and assesses the level of consciousness of a patient that has had a traumatic injury e.g. brain injury, car accident or sports injury (Braine & cook, 2016). The Glasgow coma scale is a score between 3-15 with 3 being the worst and 15 being the best. This scale is composed of 3 sections which are the best eye response this assessment is important to assess the arousal of the patient which reflexes the integrity of reticular activating system of the brain which assesses by 1. No eye opening 2. Opens to pain 3. Opens to voice 4. Opens spontaneously, the best verbal response this assessment reflects the integrity of higher cognitive and interpretive centres of the brain. The verbal response depends on the language centre in the temporal lobe and in the frontal lobe which assess 1. No verbal response 2. Incomprehensive sounds 3. Inappropriate words 4. Confused 5. Orientated and best motor response this assessment check the function ability of the cerebral cortex, the patient has to understand the commands and perform the movement accordingly, they assess the upper extremities by simple orders because they are more reliable than the lower extremities this is assessed by 1. No motor response 2. Extension to pain 3. Flexion to pain 4. Withdrawals from pain 5. Localising pain 6. Obeys commands, these are the three sections that nurses needs to access (Elliot, Aitken & Chaboyer,

Dorothy Gronwall, a concussion specialist wrote in Cumulative and Persisting Effects of Concussion on Attention and Cognition, “After MHI (mild head injury), patients have difficulty in all areas that require them to analyze more items of information than they can handle simultaneously. They present as slow because it takes longer for smaller than normal chunks of information to be processed. They present as distractible because they do not have the spare capacity to monitor irrelevant stimuli at the same time as they are attending to the relevant stimulus. They present as forgetful because while they are concentrating on point A, they do not have the processing space to think about point B simultaneously. They present as inattentive because when the amount of information that they are given exceeds their capacities, they cannot take it all in.” All of these symptoms are permanent effects that a person can have after having only mild head injury. It is clear that it is important to take care of the injuries the correct

Youngsters and teenagers ought to be assessed by a social insurance proficient prepared in assessing and overseeing pediatric blackouts. Specialists additionally prescribe that grown-up, youngster and juvenile competitors with a blackout not profit to play for that day as the damage. ("Blackout." Indications. Web. 14 Apr. 2016.) With the being said, the manifestations of a blackout the signs and side effects of a blackout can be unpretentious and may not be instantly clear. Side effects can keep going for a considerable length of time, weeks or much more. Basic manifestations after a concussive traumatic mind harm are cerebral pain, loss of memory (amnesia) and disarray. The amnesia, which could conceivably take after lost awareness, more often than not includes the loss of memory of the occasion that brought on the blackout. Incorporate cerebral pain, provisional loss of cognizance, disarray feeling as in haze, wooziness, sickness, slurred discourse and seeming entranced to give some examples. Additionally, numerous side effects which a key variable is fixation and memory misfortune, crabbiness and other identity changes, touchy to light and mental and modification issues or

The minimal brain activity was not the same between the two groups, but very similar which in itself is peculiar. Because of this the question then arises, is the patient an irregular vegetative state or perhaps something else all together? I think consciousness needs to be more defined before experiments can go trying to prove if people are or not. Furthermore, I think perhaps in this case specifically the patient in question might have been suffering more from the science community as a whole generalizing and not having enough of this type of patient show up to adequately come up with a better type of diagnosis than a vegetative state as opposed to rather or not the patient was conscious or

This can last for your whole life, and you can recover it just takes a very long time. You most likely will not, but it is very possible. Some other side effects are the loss of consciousness for a few minutes or a few seconds, state of being dazed or confused, headache, nausea or vomiting, fatigue or drowsiness, difficulty sleeping, sleeping more than usual, and dizziness or loss of balance. Long-term brain damage is bad and some of those side effects are guaranteed to happen because this is long term and there is a chance you could have all of them. Most of the time you will not be able to think straight and might have a lot of confusion at random times. According to the Mayo Clinic, the best thing would be to take coma-inducing drugs, anti-seizure drugs, and diuretics. Those will help with your memory and other side effects that are

Brain trauma can cause a build-up of an abnormal type of a protein called tau, which slowly kills brain cells. Once started, these changes in the brain appear to continue to progress even after exposure to brain trauma has ended. Possible symptoms include memory loss, confusion, impaired judgment, paranoia, impulse control problems, aggression, depression, and eventually progressive dementia. CTE can worsen a person’s condition to the point that they may develop symptoms of many other diseases such as Parkinson’s disease and Alzheimer’s disease. Symptoms can begin to appear months, years, or even decades after trauma has ended. Currently, CTE can only be diagnosed after death by brain tissue analysis. (“Chronic traumatic encephalopathy (CTE).” Encyclopedia Britannica. Encyclopedia Britannica

Even if an individual does not experience any obvious structural changes, alterations in cerebral blood flow, neuronal activity, and neurotransmitters can still be apparent.1

Patient 1 – Two individuals come to the emergency department with head injuries. One is a 25 years old, has just been in a motor vehicle accident (MVA) and has a temporal lobe injury. The other, 65 years old, has increasing confusion after a fall that happened earlier in the week.

374, para. 3). According to John Collins Harvey, a senior research scholar and professor emeritus of medicine at Georgetown University, feeding tubes should be removed from patients in PVS because there is no hope for recovery. Harvey explains that the cerebral cortex the area of the brain that controls conscious thought, language, and sensory perception has been irreparably damaged by a lack of oxygen (Harvey, 2004). However, recent studies on DOC have revealed the difficulty of diagnosing PVS, especially because a few PVS patients recovered consciousness and demonstrated awareness as a result of drug therapies and functional imaging studies (Fisher & Appelbaum, 2010). Obviously, these patients were not in PVS, an irreversible condition. The awakening of persons after the administration of specific medications brings attention to the possibility that VS is often over diagnosed (Sara & Pistoia, 2010). “The differential diagnosis of disorders of consciousness is challenging. The rate of misdiagnosis is approximately 40%, and new methods are required to complement bedside testing, particularly if the patient’s capacity to show behavioral signs of awareness is diminished” (Monti, Vanhaudenhuyse, Coleman, & Boly, 2010, para. 1).

It is also unclear if it is the brain injury itself that causes the result and if it is the same for healthy people.

Let's begin our consideration with a nine-year-old named Ryan Atencio. He was taken off life-support systems, except for a feeding tube, after being in a vegetative state following a massive head injury in a December 10, 1988 car accident. "There was no brain function," said Dr. Eustaquio Abay at St. Francis Regional

Finally, the remaining weaknesses of the GCS scale relate to the assessment of comatose patients. The GCS becomes unreliable in ongoing care for monitoring coma and recovery through vegetative or minimally conscious states, before returning to consciousness (Laureys, 2005).

These questions are difficult for any of us to answer - even more so if we are dealing with a situation in which we may have to answer one or more of these questions. Yet, for some of us, these questions are all too real. If someone is considered to be in a vegetative state and the doctor determines that they are not