Plum and Posner's Diagnosis of Stupor and Coma / Edition 4

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Overview

Delirium, stupor and coma are common clinical states that confront clinicians in almost every medical specialty. With appropriate diagnosis and treatment, coma can often be treated successfully. Conversely, delay in diagnosis and treatment may be lethal. This monograph provides an update on the clinical approach that was laid out in the previous 3 editions. It describes an approach for the physician at the bedside to diagnose and treat alterations of consciousness, based on pathophysiologic principles. The book begins with a description of the physiology of consciousness and the pathophysiology of disorders of consciousness. It continues with a description of the approach to a patient with a disorder of consciousness, emphasizing the bedside examination, but including the use of modern imaging techniques. The important structural and metabolic causes of coma are reviewed in detail. It then describes the emergency treatment, both medical and surgical, of patients with specific disorders of consciousness and their prognosis. New chapters describe the approach to the diagnosis of brain death and the clinical physiology of the vegetative state and minimally conscious state, as well as the ethics of dealing with such patients and their families.

The book is aimed at medical students and residents, in fields from internal medicine and pediatrics to emergency medicine, surgery, neurology, neurosurgery, and psychiatry, who are likely to encounter patients with disordered states of consciousness. It includes historical background and basic neurophysiology that is important for those in the clinical neurosciences, but also lays out a practical approach to the comatose patient that is an important part of the repertoire of all clinicians who provide emergency care for patients with disorders of consciousness.

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Editorial Reviews

Doody's Review Service
Reviewer: Bradley J. Robottom, MD (University of Maryland School of Medicine)
Description: This is a welcome update of a classic neurology text last revised in 1982 that focuses on the pathophysiology, etiology, and diagnosis of altered states of consciousness.
Purpose: The book offers a straightforward approach to the diagnosis and management of comatose patients. Despite the widespread availability of imaging modalities such as CT scan and MRI, the examination of the comatose patient remains the cornerstone of diagnosis and treatment. The book instructs readers how to evaluate the comatose patient in a comprehensive and timely fashion, allowing for prompt diagnosis and treatment.
Audience: Although written for neurologists, both residents in training and practicing physicians, those in other specialties, particularly those which deal with the emergent care of critically ill patients, would benefit from this book. The authors are recognized experts in the field, with the most senior authors, Plum and Posner, having written the first three editions.
Features: The book systematically addresses the pathophysiology underlying coma, the examination and diagnostic evaluation of the comatose patient, and the etiology and prognosis of coma. One chapter in particular, on the examination of the comatose patient, should be considered required reading for anyone completing a neurology residency. The authors' coverage of this topic is timeless and has changed little from earlier editions. One welcome feature of this edition is the presence of detailed, high quality images including MRI, SPECT imaging, CT perfusion scanning, and more.
Assessment: This is an excellent text, and the substantial changes since the third edition easily justify the purchase of a new copy.
From the Publisher
"The 4th edition is every bit as wonderful as the preceding 3, only with much more information...It is a wonderful clinical guide with clear descriptions of pathophysiology and application of modern technology for diagnosis."—Lewis P. Rowland, M.D., Columbia University Medical Center

"No book in any area of clinical neurology has paralleled the dominance of Plum and Posner. The Fourth Edition will sustain this preeminence and is a must for neurologists, neurosurgeons, intensivists, and emergency room physicians. We should all be grateful to the authors for presenting us with this updated gem."—Robert B. Daroff, MD, Department of Neurology, Case Western Reserve University, University Hospitals Case Medical Center

"Fred Plum and Jerome Posner wrote the first edition of The Diagnosis of Stupor and Coma to provide practical guidance and the current edition is an admirable and pleasing successor. On the basis of pedigree, coherence, and thoroughness, it is currently the last word on the subject."—New England Journal of Medicine

"Plum and Posner's book...exceeded those traditional territories and included the study of a wide range of endocrine and metabolic disorders...This is a great book and a fitting tribute to him who inspired it."—Brain

"Plum and Posners Diagnosis of Stupor and Coma is an essential text for the practicing neurologist, for the general intensivist or hospitalist, for the neurointensivist or neurosurgeon, and for the many students, residents, and fellows in the neurosciences. It stands the test of time, highlighting the legacy of Drs Plum and Posner, who have contributed so much to the field of neurology and to the training of generations of neurologists."—Wade Smith, Annals of Neurology

"This is an excellent text, and the substantial changes since the third edition easily justify the purchase of a new copy."—Doody's

"A necessity for all trainees involved in the care of the stuporous or comatose patient. This volume provides a clear framework from which to approach these clinical situations, and is highly recommended for neurosurgery residents and attendings alike."—Journal of Neurosurgery

"Over 50 years after its first edition, this book remains a gem among neurological monographs. Beyond maintaining a contemporary status, it has matured like good wine, improving over time to provide the reader with the best available summary of disorders of consciousness available on the market today...It belongs in every personal and institutional library."—European Neurology

"The book is a treasure trove of information, one of those books I will always be learning from...Everyone interested in the clinical aspects of disorders of consciousness should own a copy of this book."—Journal of Neurology, Neurosurgery, and Psychiatry

"The book is very readable and carefully arranged, and an appropriate index allows relevant content to be found quickly. The well-balanced selection of illustrations, including computed tomographic and magnetic resonance images, enriches the content and the graphics aid understanding...The fourth edition represents an excellent portrayal of the complex subject of consciousness disorders."—Archives of Neurology

"The 4th edition is every bit as wonderful as the preceding 3, only with much more information...It is a wonderful clinical guide with clear descriptions of pathophysiology and application of modern technology for diagnosis."—Lewis P. Rowland, M.D., Columbia University Medical Center

"No book in any area of clinical neurology has paralleled the dominance of Plum and Posner. The Fourth Edition will sustain this preeminence and is a must for neurologists, neurosurgeons, intensivists, and emergency room physicians. We should all be grateful to the authors for presenting us with this updated gem."—Robert B. Daroff, MD, Department of Neurology, Case Western Reserve University, University Hospitals Case Medical Center

"Fred Plum and Jerome Posner wrote the first edition of The Diagnosis of Stupor and Coma to provide practical guidance and the current edition is an admirable and pleasing successor. On the basis of pedigree, coherence, and thoroughness, it is currently the last word on the subject."—New England Journal of Medicine

"Plum and Posner's book...exceeded those traditional territories and included the study of a wide range of endocrine and metabolic disorders...This is a great book and a fitting tribute to him who inspired it."—Brain

"Plum and Posners Diagnosis of Stupor and Coma is an essential text for the practicing neurologist, for the general intensivist or hospitalist, for the neurointensivist or neurosurgeon, and for the many students, residents, and fellows in the neurosciences. It stands the test of time, highlighting the legacy of Drs Plum and Posner, who have contributed so much to the field of neurology and to the training of generations of neurologists."—Wade Smith, Annals of Neurology

"This is an excellent text, and the substantial changes since the third edition easily justify the purchase of a new copy."—Doody's

"A necessity for all trainees involved in the care of the stuporous or comatose patient. This volume provides a clear framework from which to approach these clinical situations, and is highly recommended for neurosurgery residents and attendings alike."—Journal of Neurosurgery

"Over 50 years after its first edition, this book remains a gem among neurological monographs...This book re-emphasizes the importance of neurology for proper diagnosis and management of stuporous or comatose patients. It belongs in every personal and institutional library."—European Neurology

"The book is a treasure trove of information, one of those books I will always be learning from...Everyone interested in the clinical aspects of disorders of consciousness should own a copy of this book."—Journal of Neurology, Neurosurgery, and Psychiatry

"The book is very readable and carefully arranged, and an appropriate index allows relevant content to be found quickly. The well-balanced selection of illustrations, including computed tomographic and magnetic resonance images, enriches the content and the graphics aid understanding...The fourth edition represents an excellent portrayal of the complex subject of consciousness disorders."—Archives of Neurology

"This text represents an extensive revision and update of a true classic in clinical neurology... this edition has been carefully edited to add relevant new data without altering the clinical feel of the prior work. The first three chapters alone provide adequate reason for this to be a 'must reference' available to all neurology residents and clinicians."—Neurology

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Product Details

  • ISBN-13: 9780195321319
  • Publisher: Oxford University Press
  • Publication date: 6/11/2007
  • Series: Contemporary Neurology Series , #71
  • Edition number: 4
  • Pages: 400
  • Sales rank: 760,765
  • Product dimensions: 10.10 (w) x 7.10 (h) x 0.90 (d)

Meet the Author

Memorial Sloan Kettering Cancer Center

Beth Israel Deaconess Hospital and Harvard Medical School

Weill Cornell Medical College

Cornell University

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Table of Contents

Ch. 1 The Pathologic Physiology of Signs and Symptoms of Coma 1
Ch. 2 Supratentorial Lesions Causing Coma 87
Ch. 3 Subtentorial Lesions Causing Coma 153
Ch. 4 Multifocal, Diffuse, and Metabolic Brain Diseases Causing Stupor or Coma 177
Ch. 5 Psychogenic Unresponsiveness 305
Ch. 6 Brain Death 313
Ch. 7 Prognosis in Coma 329
Ch. 8 Approach to the Unconscious Patient 349
Index 369
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