Year: 2020
Type: review
Abstract: The brainstem conveys sensory and motor inputs between the spinal cord and the brain, and contains nuclei of the cranial nerves. It controls the sleep-wake cycle and vital functions via the ascending reticular activating system and the autonomic nuclei, respectively. Brainstem dysfunction may lead to sensory and motor deficits, cranial nerve palsies, impairment of consciousness, dysautonomia, and respiratory failure. The brainstem is prone to various primary and secondary insults, resulting in acute or chronic dysfunction. Of particular importance for characterizing brainstem dysfunction and identifying the underlying etiology are a detailed clinical examination, MRI, neurophysiologic tests such as brainstem auditory evoked potentials, and an analysis of the cerebrospinal fluid. Detection of brainstem dysfunction is challenging but of utmost importance in comatose and deeply sedated patients both to guide therapy and to support outcome prediction. In the present review, we summarize the neuroanatomy, clinical syndromes, and diagnostic techniques of critical illness-associated brainstem dysfunction for the critical care setting.
Source: Critical Care
Institutions: Sorbonne Université, Hôpital Cochin, Assistance Publique – Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Institut Pasteur, Université Paris Descartes, Université de Versailles Saint-Quentin-en-Yvelines, Hôpital Raymond-Poincaré, Hôpital Paris Saint-Joseph, D’Or Institute for Research and Education, Instituto Nacional de Câncer - INCA, Columbia University, Centre National de la Recherche Scientifique, Inserm, Institut du Cerveau
Language: English
Subfield: Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,290
OpenAlex ID: W3001114059