In finishing up my posts on the ICU, I wanted to write about neurologic diseases. A substantial number of our patients have neurologic injuries, most commonly strokes and seizures. It has been a while since I've primarily cared for patients with these illnesses so I had a lot to learn. The managements of strokes, for the most part, is supportive in nature; the goal is to prevent further reinjury, to decrease brain swelling, to maintain the body's homeostasis. After many patients with these injuries, I came to know the routine and protocol pretty well. The most educational aspects, however, were learning to interpret my own films; although ultimately, we deferred to radiology and neurology, it is always very helpful to be able to look at scans immediately and make some sort of determination whether things were better or worse. I also got to practice my crude neurologic exam, relearn my antiepileptics, and have opportunities to place invasive lines for patients who needed close blood pressure monitoring and hypertonic saline.
Looking back, it was a whirlwind and exhausting month, but it reminded me how much I love medicine and things outside the operating room. It also showed me how spoiled we can be in the OR with less strenuous call schedules and fewer patients to worry over.
Image of intraparenchymal bleed with surrounding edema shown under Creative Commons Attribution Share-Alike License, from Wikipedia.
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