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ACUTE CONFUSIONALACUTE CONFUSIONALSTATES AND COMASTATES AND COMA
Confusional states and coma areConfusional states and coma areamong the most commonamong the most commonproblems in general medicine. It isproblems in general medicine. It isestimated that over 5% of estimated that over 5% of admissions to the emergencyadmissions to the emergencyward of large busy hospitals areward of large busy hospitals aredue to diseases that cause adue to diseases that cause adisorder of consciousness.disorder of consciousness. These conditions can take the These conditions can take theform of drowsiness, stupor orform of drowsiness, stupor orcoma.coma.
 
 
UNDERSTANDING THEUNDERSTANDING THEMECHANISM OF COMAMECHANISM OF COMA
Consciousness or alertness isConsciousness or alertness ismaintained by brainstem andmaintained by brainstem andthalamic neurons, the reticularthalamic neurons, the reticularactivating system and it’sactivating system and it’sconnections to the cerebralconnections to the cerebralhemispheres.hemispheres.
 
 
 
therefore structuraltherefore structuralbrainstem and thalamicbrainstem and thalamiclesions bring the patient morelesions bring the patient morelikely into coma compared tolikely into coma compared tosupratentorial (cerebral)supratentorial (cerebral)lesions.lesions.
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