Encephalopathy differential diagnosis: Difference between revisions
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| style="background: #F5F5F5; padding: 5px;" |Clinical assesment and [[EEG]] <ref name="pmid11385043">{{cite journal| author=Manford M| title=Assessment and investigation of possible epileptic seizures. | journal=J Neurol Neurosurg Psychiatry | year= 2001 | volume= 70 Suppl 2 | issue= | pages= II3-8 | pmid=11385043 | doi= | pmc=1765557 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11385043 }}</ref> | | style="background: #F5F5F5; padding: 5px;" |Clinical assesment and [[EEG]] <ref name="pmid11385043">{{cite journal| author=Manford M| title=Assessment and investigation of possible epileptic seizures. | journal=J Neurol Neurosurg Psychiatry | year= 2001 | volume= 70 Suppl 2 | issue= | pages= II3-8 | pmid=11385043 | doi= | pmc=1765557 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11385043 }}</ref> | ||
| style="background: #F5F5F5; padding: 5px;" |[[Confusion]], [[apathy]], [[irritability]], | | style="background: #F5F5F5; padding: 5px;" |[[Confusion]], [[apathy]], [[irritability]], | ||
|} | |||
===Other differentials=== | |||
Toxic encephalopathy must also be differentiated from other diseases that cause [[personality changes]], altered level of [[consciousness]] and hand [[tremors]] ([[asterixis]]). The differentials include the following:<nowiki/><ref name="pmid20495225">{{cite journal| author=Meparidze MM, Kodua TE, Lashkhi KS| title=[Speech impairment predisposes to cognitive deterioration in hepatic encephalopathy]. | journal=Georgian Med News | year= 2010 | volume= | issue= 181 | pages= 43-9 | pmid=20495225 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20495225 }} </ref><ref name="pmid25013309">{{cite journal| author=Kattimani S, Bharadwaj B| title=Clinical management of alcohol withdrawal: A systematic review. | journal=Ind Psychiatry J | year= 2013 | volume= 22 | issue= 2 | pages= 100-8 | pmid=25013309 | doi=10.4103/0972-6748.132914 | pmc=4085800 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25013309 }} </ref><ref name="pmid12813481">{{cite journal| author=Roldán J, Frauca C, Dueñas A| title=[Alcohol intoxication]. | journal=An Sist Sanit Navar | year= 2003 | volume= 26 Suppl 1 | issue= | pages= 129-39 | pmid=12813481 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12813481 }} </ref><ref name="pmid21590619">{{cite journal| author=Seifter JL, Samuels MA| title=Uremic encephalopathy and other brain disorders associated with renal failure. | journal=Semin Neurol | year= 2011 | volume= 31 | issue= 2 | pages= 139-43 | pmid=21590619 | doi=10.1055/s-0031-1277984 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21590619 }} </ref><ref name="pmid6864698">{{cite journal| author=Handler CE, Perkin GD| title=Wernicke's encephalopathy. | journal=J R Soc Med | year= 1983 | volume= 76 | issue= 5 | pages= 339-42 | pmid=6864698 | doi= | pmc=1439130 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6864698 }} </ref><ref name="pmid23251840">{{cite journal| author=Kim Y, Kim JW| title=Toxic encephalopathy. | journal=Saf Health Work | year= 2012 | volume= 3 | issue= 4 | pages= 243-56 | pmid=23251840 | doi=10.5491/SHAW.2012.3.4.243 | pmc=3521923 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23251840 }} </ref><ref name="pmid2497395">{{cite journal| author=Hartmann A, Buttinger C, Rommel T, Czernicki Z, Trtinjiak F| title=Alteration of intracranial pressure, cerebral blood flow, autoregulation and carbondioxide-reactivity by hypotensive agents in baboons with intracranial hypertension. | journal=Neurochirurgia (Stuttg) | year= 1989 | volume= 32 | issue= 2 | pages= 37-43 | pmid=2497395 | doi=10.1055/s-2008-1053998 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2497395 }} </ref><ref name="pmid21590622">{{cite journal| author=Kumar N| title=Acute and subacute encephalopathies: deficiency states (nutritional). | journal=Semin Neurol | year= 2011 | volume= 31 | issue= 2 | pages= 169-83 | pmid=21590622 | doi=10.1055/s-0031-1277986 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21590622 }} </ref><ref name="pmid23035103">{{cite journal| author=Chiu GS, Chatterjee D, Darmody PT, Walsh JP, Meling DD, Johnson RW et al.| title=Hypoxia/reoxygenation impairs memory formation via adenosine-dependent activation of caspase 1. | journal=J Neurosci | year= 2012 | volume= 32 | issue= 40 | pages= 13945-55 | pmid=23035103 | doi=10.1523/JNEUROSCI.0704-12.2012 | pmc=3476834 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23035103 }} </ref><ref name="pmid15284663">{{cite journal| author=Peate I| title=An overview of meningitis: signs, symptoms, treatment and support. | journal=Br J Nurs | year= 2004 | volume= 13 | issue= 13 | pages= 796-801 | pmid=15284663 | doi=10.12968/bjon.2004.13.13.13501 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15284663 }} </ref><ref name="pmid25821643">{{cite journal| author=Abdelhafiz AH, Rodríguez-Mañas L, Morley JE, Sinclair AJ| title=Hypoglycemia in older people - a less well recognized risk factor for frailty. | journal=Aging Dis | year= 2015 | volume= 6 | issue= 2 | pages= 156-67 | pmid=25821643 | doi=10.14336/AD.2014.0330 | pmc=4365959 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25821643 }} </ref> | |||
{| | |||
|- style="background: #4479BA; color: #FFFFFF; text-align: center;" | |||
! rowspan="2" |Diseases | |||
! colspan="3" |History and Symptoms | |||
! colspan="4" |Physical Examination | |||
! colspan="3" |Laboratory Findings | |||
|- style="background: #4479BA; color: #FFFFFF; text-align: center;" | |||
!Personality changes | |||
!Altered level of consciousness | |||
!Hand tremors (asterixis) | |||
!Slurred speech | |||
!Writing disturbances | |||
!Voice monotonous | |||
!Impaired '''memory''' | |||
!Elevated blood ammonia | |||
!Hyponatremia | |||
!hypokalemia | |||
|- | |||
|'''Hepatic encephalopathy''' | |||
| ++ | |||
| ++ | |||
| ++ | |||
|<nowiki>++</nowiki> | |||
|<nowiki>++</nowiki> | |||
|<nowiki>++</nowiki> | |||
|<nowiki>++</nowiki> | |||
|<nowiki>++</nowiki> | |||
|<nowiki>++</nowiki> | |||
|<nowiki>++</nowiki> | |||
|- | |||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Alcohol intoxication]]''' | |||
| style="background: #F5F5F5; padding: 5px;" | + | |||
| style="background: #F5F5F5; padding: 5px;" | + | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
| style="background: #F5F5F5; padding: 5px;" | ++ | |||
| style="background: #F5F5F5; padding: 5px;" | + | |||
| style="background: #F5F5F5; padding: 5px;" | - | |||
| style="background: #F5F5F5; padding: 5px;" | + | |||
| style="background: #F5F5F5; padding: 5px;" | - | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
|- | |||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Alcohol withdrawal]]''' | |||
| style="background: #F5F5F5; padding: 5px;" | + | |||
| style="background: #F5F5F5; padding: 5px;" | + | |||
| style="background: #F5F5F5; padding: 5px;" | - | |||
| style="background: #F5F5F5; padding: 5px;" | ++ | |||
| style="background: #F5F5F5; padding: 5px;" | + | |||
| style="background: #F5F5F5; padding: 5px;" | - | |||
| style="background: #F5F5F5; padding: 5px;" | + | |||
| style="background: #F5F5F5; padding: 5px;" | - | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
|- | |||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Uremia]]''' | |||
| style="background: #F5F5F5; padding: 5px;" | ++ | |||
| style="background: #F5F5F5; padding: 5px;" | ++ | |||
| style="background: #F5F5F5; padding: 5px;" | + | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
| style="background: #F5F5F5; padding: 5px;" | | |||
| style="background: #F5F5F5; padding: 5px;" | - | |||
| style="background: #F5F5F5; padding: 5px;" | ++ | |||
| style="background: #F5F5F5; padding: 5px;" |[[Hyperkalemia]] | |||
|- | |||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Wernicke encephalopathy]]''' | |||
| style="background: #F5F5F5; padding: 5px;" | + | |||
| style="background: #F5F5F5; padding: 5px;" | + | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
| style="background: #F5F5F5; padding: 5px;" | + | |||
| style="background: #F5F5F5; padding: 5px;" | + | |||
| style="background: #F5F5F5; padding: 5px;" | + | |||
| style="background: #F5F5F5; padding: 5px;" | ++ | |||
| style="background: #F5F5F5; padding: 5px;" | - | |||
| style="background: #F5F5F5; padding: 5px;" | - | |||
| style="background: #F5F5F5; padding: 5px;" | - | |||
|- | |||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Toxic encephalopathy]] from drugs''' | |||
| style="background: #F5F5F5; padding: 5px;" | + | |||
| style="background: #F5F5F5; padding: 5px;" | + | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
| style="background: #F5F5F5; padding: 5px;" | + | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
| style="background: #F5F5F5; padding: 5px;" | + | |||
| style="background: #F5F5F5; padding: 5px;" | + | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
|- | |||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Altered [[intracranial pressure]]''' | |||
| style="background: #F5F5F5; padding: 5px;" | + | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
| style="background: #F5F5F5; padding: 5px;" | - | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
| style="background: #F5F5F5; padding: 5px;" | - | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
| style="background: #F5F5F5; padding: 5px;" | - | |||
| style="background: #F5F5F5; padding: 5px;" | - | |||
| style="background: #F5F5F5; padding: 5px;" | - | |||
|- | |||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Intoxication by chemical agents''' | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
| style="background: #F5F5F5; padding: 5px;" | - | |||
| style="background: #F5F5F5; padding: 5px;" | - | |||
| style="background: #F5F5F5; padding: 5px;" | - | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
|- | |||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Malnutrition]]''' | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
| style="background: #F5F5F5; padding: 5px;" | - | |||
| style="background: #F5F5F5; padding: 5px;" | - | |||
| style="background: #F5F5F5; padding: 5px;" | - | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
| style="background: #F5F5F5; padding: 5px;" | - | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
| style="background: #F5F5F5; padding: 5px;" | - | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
|- | |||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Hypoxic brain injury]]''' | |||
| style="background: #F5F5F5; padding: 5px;" | - | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
| style="background: #F5F5F5; padding: 5px;" | - | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
| style="background: #F5F5F5; padding: 5px;" | - | |||
| style="background: #F5F5F5; padding: 5px;" | - | |||
| style="background: #F5F5F5; padding: 5px;" | - | |||
|- | |||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Meningitis]] and [[encephalitis]]''' | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
| style="background: #F5F5F5; padding: 5px;" | - | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
| style="background: #F5F5F5; padding: 5px;" | + | |||
| style="background: #F5F5F5; padding: 5px;" | - | |||
| style="background: #F5F5F5; padding: 5px;" | - | |||
| style="background: #F5F5F5; padding: 5px;" | - | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
| style="background: #F5F5F5; padding: 5px;" | - | |||
|- | |||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''[[Hypoglycemia]]''' | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
| style="background: #F5F5F5; padding: 5px;" | - | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
| style="background: #F5F5F5; padding: 5px;" | - | |||
| style="background: #F5F5F5; padding: 5px;" | - | |||
| style="background: #F5F5F5; padding: 5px;" | - | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
| style="background: #F5F5F5; padding: 5px;" | -/+ | |||
|} | |} | ||
Revision as of 19:09, 24 January 2018
Encephalopathy |
Diagnosis |
---|
Treatment |
Encephalopathy differential diagnosis On the Web |
American Roentgen Ray Society Images of Encephalopathy differential diagnosis |
Risk calculators and risk factors for Encephalopathy differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2]
Overview
Encephalopathy can present in many ways mimicking many other brain conditions. Certain conditions like encephalitis, meningitis, brain tumors, epilepsy, and overdosing of certain medications may mimic encephalopathy.
Differentiating from other symptoms
The symptoms of encephalopathy may overlap with the symptoms of other diseases:
- Encephalitis which is differentiated from encephalopathy by the presence of fever and other signs and symptoms of a viral infection.
- Meningitis which is differentiated from encephalopathy by the presence of neck stiffness, headache, meningeal signs, fever
- Postictal state which would be differentiated by the presence of seizures
- Intracranial lesions like tumors, masses, granulomas which are differentiated by the presence of focal neurologic signs and symptoms
Encephalopathy must be differentiated from other causes of headache,seizures and loss of consciousness.
Diseases | Symptoms | Physical Examination | Past medical history | Diagnostic tests | Other Findings | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Headache | ↓LOC | Motor weakness | Abnormal sensory | Motor Deficit | Sensory deficit | Speech difficulty | Gait abnormality | Cranial nerves | CT /MRI | CSF Findings | Gold standard test | |||
Meningitis | + | - | - | - | - | + | + | - | - | History of fever and malaise | - | ↑ Leukocytes,
↑ Protein ↓ Glucose |
CSF analysis[1] | Fever, neck |
Encephalitis | + | + | +/- | +/- | - | - | + | +/- | + | History of fever and malaise | + | ↑ Leukocytes, ↓ Glucose | CSF PCR | Fever, seizures, focal neurologic abnormalities |
Brain tumor[2] | + | - | - | - | + | + | + | - | + | Weight loss, fatigue | + | Cancer cells[3] | MRI | Cachexia, gradual progression of symptoms |
Hemorrhagic stroke | + | + | + | + | + | + | + | + | - | Hypertension | + | - | CT scan without contrast[4][5] | Neck stiffness |
Subdural hemorrhage | + | + | + | + | + | - | - | - | + | Trauma, fall | + | Xanthochromia[6] | CT scan without contrast[4][5] | Confusion, dizziness, nausea, vomiting |
Neurosyphilis[7][8] | + | - | + | + | + | + | - | + | - | STIs | + | ↑ Leukocytes and protein | CSF VDRL-specifc
CSF FTA-Ab -sensitive[9] |
Blindness, confusion, depression,
Abnormal gait |
Complex or atypical migraine | + | - | + | + | - | - | + | - | - | Family history of migraine | - | - | Clinical assesment | Presence of aura, nausea, vomiting |
Hypertensive encephalopathy | + | + | - | - | - | - | + | + | - | Hypertension | + | - | Clinical assesment | Delirium, cortical blindness, cerebral edema, seizure |
Wernicke’s encephalopathy | - | + | - | - | - | + | + | + | + | History of alcohal abuse | - | - | Clinical assesment and lab findings | Ophthalmoplegia, confusion |
CNS abscess | + | + | - | - | + | + | + | - | - | History of drug abuse, endocarditis, immunosupression | + | ↑ leukocytes, ↓ glucose and ↑ protien | MRI is more sensitive and specific | High grade fever, fatigue,nausea, vomiting |
Drug toxicity | - | + | - | + | + | + | - | + | - | - | - | - | Drug screen test | Lithium, Sedatives, phenytoin, carbamazepine |
Conversion disorder | + | + | + | + | + | + | + | + | History of emotional stress | - | - | Diagnosis of exclusion | Tremors, blindness, difficulty swallowing | |
Metabolic disturbances (electrolyte imbalance, hypoglycemia) | - | + | + | + | + | + | - | - | + | - | - | Hypoglycemia, hypo and hypernatremia, hypo and hyperkalemia | Depends on the cause | Confusion, seizure, palpitations, sweating, dizziness, hypoglycemia |
Multiple sclerosis exacerbation | - | - | + | + | - | + | + | + | + | History of relapses and remissions | + | ↑ CSF IgG levels
(monoclonal bands) |
Clinical assesment and MRI [10] | Blurry vision, urinary incontinence, fatigue |
Seizure | + | + | - | - | + | + | - | - | + | Previous history of seizures | - | Mass lesion | Clinical assesment and EEG [11] | Confusion, apathy, irritability, |
Other differentials
Toxic encephalopathy must also be differentiated from other diseases that cause personality changes, altered level of consciousness and hand tremors (asterixis). The differentials include the following:[12][13][14][15][16][17][18][19][20][21][22]
Diseases | History and Symptoms | Physical Examination | Laboratory Findings | |||||||
---|---|---|---|---|---|---|---|---|---|---|
Personality changes | Altered level of consciousness | Hand tremors (asterixis) | Slurred speech | Writing disturbances | Voice monotonous | Impaired memory | Elevated blood ammonia | Hyponatremia | hypokalemia | |
Hepatic encephalopathy | ++ | ++ | ++ | ++ | ++ | ++ | ++ | ++ | ++ | ++ |
Alcohol intoxication | + | + | -/+ | ++ | + | - | + | - | -/+ | -/+ |
Alcohol withdrawal | + | + | - | ++ | + | - | + | - | -/+ | -/+ |
Uremia | ++ | ++ | + | -/+ | -/+ | -/+ | - | ++ | Hyperkalemia | |
Wernicke encephalopathy | + | + | -/+ | + | + | + | ++ | - | - | - |
Toxic encephalopathy from drugs | + | + | -/+ | -/+ | + | -/+ | + | + | -/+ | -/+ |
Altered intracranial pressure | + | -/+ | - | -/+ | -/+ | - | -/+ | - | - | - |
Intoxication by chemical agents | -/+ | -/+ | -/+ | -/+ | -/+ | - | - | - | -/+ | -/+ |
Malnutrition | -/+ | - | - | - | -/+ | - | -/+ | - | -/+ | -/+ |
Hypoxic brain injury | - | -/+ | - | -/+ | -/+ | -/+ | -/+ | - | - | - |
Meningitis and encephalitis | -/+ | -/+ | - | -/+ | + | - | - | - | -/+ | - |
Hypoglycemia | -/+ | -/+ | - | -/+ | -/+ | - | - | - | -/+ | -/+ |
References
- ↑ Carbonnelle E (2009). "[Laboratory diagnosis of bacterial meningitis: usefulness of various tests for the determination of the etiological agent]". Med Mal Infect. 39 (7–8): 581–605. doi:10.1016/j.medmal.2009.02.017. PMID 19398286.
- ↑ Morgenstern LB, Frankowski RF (1999). "Brain tumor masquerading as stroke". J Neurooncol. 44 (1): 47–52. PMID 10582668.
- ↑ Weston CL, Glantz MJ, Connor JR (2011). "Detection of cancer cells in the cerebrospinal fluid: current methods and future directions". Fluids Barriers CNS. 8 (1): 14. doi:10.1186/2045-8118-8-14. PMC 3059292. PMID 21371327.
- ↑ 4.0 4.1 Birenbaum D, Bancroft LW, Felsberg GJ (2011). "Imaging in acute stroke". West J Emerg Med. 12 (1): 67–76. PMC 3088377. PMID 21694755.
- ↑ 5.0 5.1 DeLaPaz RL, Wippold FJ, Cornelius RS, Amin-Hanjani S, Angtuaco EJ, Broderick DF; et al. (2011). "ACR Appropriateness Criteria® on cerebrovascular disease". J Am Coll Radiol. 8 (8): 532–8. doi:10.1016/j.jacr.2011.05.010. PMID 21807345.
- ↑ Lee MC, Heaney LM, Jacobson RL, Klassen AC (1975). "Cerebrospinal fluid in cerebral hemorrhage and infarction". Stroke. 6 (6): 638–41. PMID 1198628.
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