[Present state of initial treatment of neurological abnormalities and the development faculties of emergency physicians].
In an emergency room, attending doctors encounter various neurological symptoms and signs on a daily basis. Every doctor aims to identify abnormal findings, achieve a diagnosis, and offer appropriate management. In Japan, currently, only approximately 35% of leading emergency centers have neurologists, neurosurgeons, and psychiatrists performing exclusive functions. Therefore, the initial or tentative diagnosis of a patient with cerebral symptoms is dealt by emergency physicians. For instance, in a patient presenting with hemiparesis, prompt detection of an acute cerebral infarction, which has a highly limited therapeutic window for thrombolytic therapy, is crucial. However, this symptom may also be observed in some cases of severe hypoglycemia, psychogenic reaction (conversion hysteria), etc. This report describes a strategy for accurate diagnosis and medical treatment of neurological abnormalities at the emergency rooms of hospitals, which are expected to provide this support.
Unemoto
Kyoko
K
Department of Emergency and Critical Care Medicine, Nippon Medical School, Musashikosugi Hospital, 1-396 Musashikosugi, Nakahara-ku, Kawasaki, Kanagawa 211-8533, Japan.
Yokota
Hiroyuki
H
D002544:Cerebral Infarction / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D003244:Consciousness Disorders / Q000628:therapy; D003291:Conversion Disorder / Q000150:complications; D003937:Diagnosis, Differential; D004635:Emergency Medicine; D004636:Emergency Service, Hospital; D006801:Humans; D006973:Hypertension; D007003:Hypoglycemia / Q000150:complications; D007022:Hypotension; D009422:Nervous System Diseases / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D010291:Paresis / Q000209:etiology; D010820:Physicians; D015912:Thrombolytic Therapy