brief interruption of consciousness

Introduction

Introduction A transient loss of consciousness caused by transient ischemia and hypoxia in the brain. Atherosclerosis, which supplies cerebral blood circulation, is the most common cause of transient ischemic attacks. The most common is the formation of carotid atherosclerotic thrombosis, often leading to stenosis of the lumen, resulting in reduced blood flow to the supply of the brain. Also causing this symptom is an arterial-arterial thromboembolism, which is derived from the ulcer surface of the carotid or vertebral artery atherosclerotic plaque of the neck, or less from the walled thrombus in the heart; The most common causes of cardiac emboli are atrial fibrillation, valvular disease, and left ventricular thrombosis.

Cause

Cause

Vascular nerve factors, arrhythmia, or orthostatic hypotension are the most common causes.

Atherosclerosis, which supplies cerebral blood circulation, is the most common cause of transient ischemic attacks. The most common is the formation of carotid atherosclerotic thrombosis, often leading to stenosis of the lumen, resulting in reduced blood flow to the supply of the brain.

Also causing this symptom is an arterial-arterial thromboembolism, which is derived from the ulcer surface of the carotid or vertebral artery atherosclerotic plaque of the neck, or less from the walled thrombus in the heart; The most common causes of cardiac emboli are atrial fibrillation, valvular disease, and left ventricular thrombosis.

Less common causes are hemodynamic changes, a brief decrease in blood flow, such as orthostatic hypotension, and heart disease.

Examine

an examination

Related inspection

State of consciousness

Examination and diagnosis of a brief interruption of consciousness:

A detailed understanding of the patient's medical history, careful examination of the body (including blood pressure measurement) and electrocardiogram examination are the three basic elements for diagnosing and judging the cause.

Diagnosis

Differential diagnosis

Identification of symptoms that are easily confused by a brief interruption of consciousness:

It is not difficult to identify symptoms such as syncope and dizziness and falls. However, epilepsy and syncope have a transient loss of consciousness, which is sometimes confusing in the clinic. For a long time, patients can be identified by using EEG on epileptic discharge or sharp wave or spine-slow wave.

Epilepsy and epileptic seizures: Epileptic seizures and epilepsy are characterized by a group of diseases and syndromes characterized by transient central nervous system dysfunction caused by recurrent abnormalities in the course of the disease. According to the range of neurons and the extent of discharge diffusion, dysfunction may manifest as different obstacles such as exercise, sensation, consciousness, behavior, autonomic nerve, or both. Each episode or each episode is called a seizure. The patient may have one or several painful epileptic seizures.

Fainting: Syncope refers to a sudden loss of transient consciousness caused by a sudden, transient, insufficient blood supply to the brain. It is caused by physical factors and can also be secondary to blood circulation disorders in the brain. Its clinical features are acute onset and loss of transient consciousness. Patients often have prodromal symptoms about one minute before the onset of syncope, manifested as general discomfort, blurred vision, tinnitus, nausea, pale, cold sweat, limb weakness, and soon syncope. At the onset of syncope, casual exercise and loss of sensation, sometimes apnea, slow heart rate, and even cardiac arrest, it is difficult to touch the radial artery and the carotid artery. Neurological examination can reveal dilated pupils, loss of light reflection and corneal reflexes, reduction or disappearance of sputum reflexes, pathological reflexes, often accompanied by salivation and urinary incontinence. It usually lasts for 2-3 minutes, and all functions are gradually restored. After the patient wakes up, there may be a short period of conscious turbidity, abdominal discomfort, nausea, vomiting, constipation, even incontinence, extreme fatigue, lethargy, duration of a few minutes to half an hour, after the onset of examination can be no positive signs.

A detailed understanding of the patient's medical history, careful examination of the body (including blood pressure measurement) and electrocardiogram examination are the three basic elements for diagnosing and judging the cause.

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