is usually carried out in direct and lateral projections, sometimesin the special projections. In recent years, it is used less frequently with the introduction of CT and MRI,which is much more informative. X-ray of the skull is used to identify a set of fractures and skull base,pathological calcification within the skull, hyperostosis of the skull bones, and their destruction,malformations of the skull.
- a method study of brain activity. In the period of wakefulness in humansnormally occur predominantly -rhythm (8-12 Hz) and (-rhythm (14-40 Hz). Pathology can appear asslow rhythms (-rhythm and -rhythm) and epileptic activity (spikes , sharp wave complexes peak-slowwave). To increase the sensitivity of the method, provocative tests (photic stimulation, hyperventilation,etc.) can be used. EEG is used in the diagnosis of brain death.
method of ultrasound examination of the brain, based on regstrationof reflections of the echo signals from the brain structures. Main value is signal marks which arereflected from middle structures (M-echo). In major process of cerebellar hemisphere of the brain,middle structures of the brain can shift which leads to a shift of M-echo at 2 mm n more from the middleposition, but the lack of displacement M-echo, does not rule out brain damage.
Causes of impaired consciousness. Destructive and metabolic coma.
Disturbance of consciousness may be caused by both organic brain damage (destructive coma), and itsdysfunction due to toxic and metabolic disorders (metabolic coma). Destructive coma is possible inextensive lesions of the cerebral hemispheres, and with a small lesion of the upper parts of the brainstem and midbrain, exciting reticular activating system. The main causes of destructive coma - braininjury, stroke, intracranial infection (meningitis, encephalitis), brain tumor, status epilepticus. Metaboliccoma may develop during hypoglycemia or hyperglycemia, diabetic ketoacidosis, uremia, hepatic failure,hyponatremia, hypothyroidism, hypercalcemia or hypocalcemia , severe heart and/or pulmonary disease,Gaye-Wernicke encephalopathy, acute hypertensive encephalopathy, as well as poisoning (alcohol,drugs, drugs, heavy metals, carbon monoxide, etc.), thermal injury (heat stroke, hypothermia).Determining the causes of coma is important to give information about the features of its development,prior to injuries and diseases, alcohol, drugs and medicines. Acute impairment of consciousness is moreoften observed in stroke, brain trauma, or hypoglycemia, gradually develops over several hours - withintracranial infection, brain tumors, metabolic disorders, and poisoning.Unilateral widening of the pupil is typical in major process (intracranial hematoma, tumor), although itshould be borne in mind that anisocoria is noted in the mild, almost 10% of healthy individuals and maybe the result of injury or operations on the eye. Narrow pupils (less than 1 mm) observed athemorrhagesof the pons, barbiturate or narcotics poisoning. Preservation of pupillary reactions in deepconsciousness is characteristic of metabolic disorders. Vertical exotropia and float movement of theeyeballs are observed in destructive lesions of the upper parts of the brain stem.Urgent therapeutic measures in a coma include providing airway and adequate ventilation of the lungs,circulatory system stabilization, the introduction of IV 30-50 ml of 40% of the first glucose (for suspectedhypoglycemia) and 100 mg of thiamine (for suspected acute encephalopathy Gaye - Wernicke),normalization of body temperature. Then determine the cause of impaired consciousness and carry outmeasures (control of blood pressure and respiration, skin care, parenteral nutrition and bowelmovements, bladder control, etc.), warning of multiple complications of coma. After determining it,treat the causes of coma, such as antibiotic therapy for meningitis, dehydration with cerebral edemacaused by cranial trauma or tumor.