Index

Italic page numbers refer to fgures and Bold page numbers refer to tables.

A mechanical respiratory failure, 139 Abdominal refexes, 50 mechanical ventilation, 140 Abnormal consciousness, 104 Acute STroke Registry and Analysis of Lausanne Abnormal movements, 57 (ASTRAL), 21 Abnormal past-pointing tests, 54 Acute vertigo and nystagmus, 53, 54 Absent motor response, 132 Acute weakness and respiratory failure, 156, 156 Absent tendon refexes, 50 Adult-onset Pompe disease, 167 Acute bacterial meningitis, 149 Afferent pupillary defect, 48 Acute blindness, 52 Air hunger, 159 Acute bowel ischemia, 100 Akinesia, 66 Acute brain injury, 173, 175 Alberta stroke program early CT scan (ASPECTS) Acute cauda equina syndrome, 143 score, 14, 23 Acute CNS infections, 98–99 Alcohol intoxication, 81 Acute confusional state, 105 Altered consciousness, 78, 104–107, 104 Acute diplopia (monocular/binocular), 51 Altered unconsciousness, 104, 104

Acute dysautonomia, on respiratory function, 140 Alveolar hypoventilation and impaired CO2 exchange, 161 Acute dystonic reaction, 63, 64 American congress of rehabilitation medicine, 113 Acute gait freezing, 66 Amyotrophic lateral sclerosis (ALS), 159 Acute injury, to brain/brainstem, 100 Analgosedation, 74 Acute intracerebral hemorrhage (ICH), 181 Analogosedative drug combinations, 72 Acute leukoencephalopathy, 80 Anchoring, 4 Acute movement disorder, 59, 59 Ancillary tests, 124, 132, 133, 135 Acute myelopathy, 139 Anesthetic drugs and paralytic agents, 36 Acute neurohistory, 2, 2 Aneurysmal subarachnoid hemorrhage, 7, 21, Acute neurologic illness, 196 95, 96, 181, 182 Acute neurology and neurocritical care, 13 Anoxic–ischemic encephalopathy, 182–183 Acute neuromuscular cardiac and circulatory disease, 164 Anterior circulation syndromes, 39 Acute neuromuscular disease Anterior cord syndrome, 142 accessory inspiratory muscles, 160 Antibiotics, 76 clinical syndromes, 153 Anticholinergic/sympathomimetic toxidrome, 80 oropharyngeal muscles, 160 Anticipated poor prognosis, 174, 174 respiratory load, 160 Antiepileptic drugs, 64 skin and muscle movement, 156 Aortic aneurysm repairs, 139, 148 Acute neuromuscular disorders, 175, 184, 185 Aphasia, 44, 89, 177, 195 Acute neuromuscular respiratory failure, 159 classifcation, 43, 43 Acute parkinsonism, 60, 60 Quotient, 177 Acute physiology and chronic health evaluation II recovery, 177 (APACHE II) score, 21 severity, 177 Acute respiratory distress syndrome (ARDS), 8 Apnea test, 128–130 Acute respiratory failure with labored breathing, 62 in ECMO-changing sweep vs. CO blending, 130, 131 Acute reversal of neuromuscular blockage, 75, 75 in extracorporeal membrane oxygenation, 130 Acute spinal cord disease, diagnostic considerations, 147, 147 safety, 120 Acute spinal cord injury, 185 terminations, 129

© Mayo Foundation for Medical Education and Research, under exclusive license to Springer 205 Nature Switzerland AG 2021 E. F. M. Wijdicks, Examining Neurocritical Patients, https://doi.org/10.1007/978-3-030-69452-4 206 Index

Apneic oxygenation-diffusion, 127 sedative drug effect, 122 Arbitrary numerical cut-offs for therapeutic intervention, 25 sequential systematic steps in examination, 119 Arsenic and thallium poisonings, 156 spinal responses, 127 Arterial blood-gas measurements, 162 structural injury, 123 Arteriovenous malformation-related intracerebral systolic blood pressure, 123 hemorrhage (AVICH) score, 30 tendon refexes, 123 Asia impairment for spinal cord injury, 145, 146 testing, 125, 135 Asomatognosia, 178 Brain edema, 78 Aspect score, 24 Brain-function studies, 113 Astereognosis, 49 Brain parenchyma, 91 Autoimmune mechanism, 155 BRAIN score, 21 Axial myoclonus, 60, 61 Brain swelling, 91 Axonal injury, 154 Brain tissue shift and brainstem injury, 93, 93 Brainstem displacement, 92 Brainstem injury, bi-hemispheric necrosis, 120 B Brainstem refexes, 44–48, 46, 47, 109, 123 Babinski signs, 143 Brainstem syndromes, 92 Back pain, 148 Breathing pattern in tetraplegia, 146, 146 Baroreceptor sensitivity, 165 Broca’s aphasia, 39 Barriers to communication, 198 Bronchial function, 163 Barrow neurological institute (BNI), 23 Brown-Séquard syndrome, 142 Basilar artery occlusion, 7 Bedside screening tests, 108 Beevor sign, 143 C Benzodiazepine, 75 Caloric testing, 126 Bifrontal/temporal-lobe hematoma, 95 Canadian neurological scale, 20 Bihemispheric cortical injury, 109 Carbon-dioxide augmentation, 128 Bi-hemispheric syndrome, 92 Cardiac arrest, sudden appearance of hypotension, 129 Bilateral corticospinal-tract involvement, 90 Cardiac arrhythmias, 130 Bilateral forebrain, 59 Cardiac phenotypes, 166 Bilateral leg pain, 143 Cardiovascular compensation to hypoxemia, 77 Bilateral visual loss, 52 Carotid artery syndrome, 39 Bladder impairment, in cauda equina syndrome, 143 Catastrophic brain injury, 174, 185, 198 Bleeding assessment tool (BAT) score, 21 Catatonia, 195 Blood brain barrier (BBB), 75 Cauda equina, 148 Blood pressure control, 181 Causal simplicity, 4 Body awareness, 177 Central brainstem displacement, 93 Bradycardia, 166 Central cord syndrome, 142 Brain death Central nervous system (CNS) depressants, 106 absent corneal refexes, 124 Central nervous system (CNS) infections, 8 acid-based disturbance, 123 in immunocompromised patients, 183, 184 ancillary tests, 120 Centronuclear myopathy, 155 assessment, 119 Cerebellar ataxia, 82 causes, 134 Cerebellar dysarthria, 44 cerebrospinal fuid, 122 Cerebellar function testing, 49 clinical determination, 119 Cerebellar hematoma, 97 clinical examination, 120, 121 Cerebral edema, 8 determination in neonates, 131, 132 Cerebral hematoma, 96, 97 facial and ocular trauma, 124 Cerebral hemorrhage, 181 fow-triggered mode, 123 Cerebral performance category (CPC), 18, 26 light response, 124 Cerebral venous sinus thrombosis (CVST), 7 loss of brain function, 122 Cerebrospinal fuid (CSF) pressure, 91 loss of brainstem function, 119 Cervical myelopathy, 82 medical/neurosurgical intervention, 119 Changed motor/verbal response, 89 muscle relaxants, 123 Checkpoint inhibitor-induced myositis, 159 neurocritical care fundamentals, 120 Chest-wall mechanics, 160 ocular instillation of drugs and trauma, 124 Cheyne–stokes respiration and irregular breathing, 16 pressure triggering, 124 Chloramphenicol, 76 response to bright light, 124 Chorea, 60 retained breathing drive, 124 Chronic myopathies, 155 Index 207

Clinical spinal cord syndromes Diaphragmatic weakness, 163 cervical cord lesions, 142 Diffuse axonal brain injury, 7 extubation, 149 Diplopia, 51, 52, 52 localization principles, 142 Disability rating scale, 19 motor weakness, 142 Disorders of consciousness (DOC), 115 palpation of muscles, 143 Disorders of vestibulospinal refexes, 54 poikilothermic, 144 Disorientation, 104 rectal sensation, 144 Distal collateral artery connections, 39 respiratory diffculties, 144, 146, 147 Disturbances of consiciousness, 103, 103 sensory levels, 142 Downward eye deviation, 44 Clinimetry, 13, 14 Drug-induced myoclonus, 62 Clotted blood/cerumen in ear, 126 Drug-induced oculogyric crises, 63 Clouding of consciousness, 103 Drug infusions, 84 Cognitive errors, 9 Drug interactions, 72 Cognitive motor dissociation (CMD), 115 Drug overdose, 2 Cold stimulus, 126 Drugs prolonging clearance of sedatives and analgesic Coma, 104, 108, 116, 121 agents, 73 Coma associated with structural damage, 172 Dysarthria, 44 Coma scales, 14–18 Dysautonomia, 164, 165, 167 Coma vigil, 112 Dysdiadochokinesis, 49 Comatose patient, 108–110, 110 Dyskinesias, 60, 60 Communication bumfuzzles, 192, 192 Dysphagia, 178 Communication curve balls, 199, 199 Dystonia, 60 Communication defense mechanisms, 196, 197 Communication errors, 190 Communication network, 190, 190 E Communication skills, 191 Edinger westphal nucleus, 45 Communication with physician inside hospital, 193 Electronic devices, 200 Communication with physician outside hospital, 192 Electronic records, 189 Communication, risks, 191 Embolus to basilar artery, 6 Compression on brainstem, 174 Emery-Dreifuss muscular dystrophies (EDMD), 167 Confrmation bias, 3 Encephalitis, 98 Continuous positive airway pressure (CPAP) with Encephalopathy, 104 pressure-support ventilation (PSV), 164 Enteral nutrition, 178 Contusional hematoma, 82 Epidural spinal abscess, 148 Cortical infarctions, 98 Erasmus GBS respiratory insuffciency score Cortical irritation, 58 (EGRIS), 23, 31 Cough, 126 Errors of commission, 2 Cranial nerve VI, 91 Excess (hyperkinetic) movements, 57 CRASH databases, 20, 178, 180 Executive function test, 108 Critical illness myopathy (and neuropathy), 159 Extensor posturing, 7 CYP 3A4 inhibitors, 74 Extracorporeal Life Support Organization (ELSO) ECLS Registry report, 130 Extracranial blood, 8 D Extreme hereditary neuropathies, 158 Decorticate posturing, 111 Eye movements, 113 Defciencies in neurologic skills, 36 Eye muscles and function, 50, 51 Delayed cerebral ischemia (DCI), 23, 96 Delayed epidural hematoma, 95 Delirium, 105, 106, 196 F at bedside, 106 Facial movement to noxious stimuli, 126 types, 103 Facial muscle score (FMS), 22 Dermatomyositis rash, 38 False localizing signs, 81, 82 Detecting clinical worsening, 87 Families communication, 197, 198 Deterioration in stroke, 89, 89 Fentanyl, 66, 74, 80 Deterioration in traumatic brain injury, 95 Finger-to-nose testing, 49 Deterioration, neurocritical conditions, 94, 94 Fluctuating consciousness, 89 Dexmedetomidine, 72 Fluctuating consciousness with transient eye deviation, 90 Diagnostic errors, 9 Fluctuating defcits, 98 Diaphragm dysfunction, 163 Flumazenil, 75 208 Index

Focal and multifocal neuropathies, 154 Hypocalcemia, 78 Focal seizure, 58 Hypokinetic emergencies, 62 Forced eye deviation, 126 Hypokinetic movements, 60 Forced vital capacity (FVC) values, 22 Hypomagnesaemia, 74 Frontal eye felds, 44 Hyponatremia, 77 Frontocerebellar pathway damage, 81 Hypotension, 77 Full outline of unresponsiveness (FOUR) score, 16–18, Hypotension without hypoxemia, 130 17, 113, 116 Hypothermia, 74 Functional independence measure (FIM) score, 19, 28, Hypotonia, 156 176, 176, 177 Hypoxemia, 77 Functional interactive communication, 115 Hypoxemic respiratory failure, 100 Functional movement disorders, 67 Hypoxemic-hypercapnic respiratory failure, 162 Functional Oral Intake Scale (FOIS), 178, 178 Hypoxia, 77

G I Gait abnormalities, 50 Ictal-interictal continuum, 90 Gag refexes, 126 Illicit drugs and neurologic manifestations, 79, 79 Ganglionic hemorrhage, 96 Imminent neuromuscular respiratory failure Ganglion/neuron cell body neuronopathy, 155 in GBS, 163 Generalized myoclonus, 49, 63, 112 Immune-mediated neuropathies, 155 Generalized periodic discharges (GPDs), 90 Impaired cognition, 183 Glasgow coma scale (GCS), 14, 15, 15, 16, 18, 20, 25, Impaired consciousness, 98 29, 108 Incentive spirometry, 164 Glasgow global outcome scale, 18 Intensive Blood Pressure Reduction in Acute Cerebral Glasgow outcome scale, 19 Hemorrhage Trial 2 (INTERACT2 trial), 181 Glasgow outcome scale-extended (GOSE), 19 International classifcation of functioning, disability Glasgow outcomescale, 26 and health, 19 Gradual deterioration, 95 International mission for prognosis and analysis of Grimacing, 114 clinical trials in traumatic brain injury Guillain–Barré syndrome (GBS), 8, 31, 167 (IMPACT), 20, 178, 179 Internuclear ophthalmoplegia, 48 Inter-observer reliability, 14 H Intoxications, 79 Hand movements, 49 Intracerebral Hemorrhage (ICH) Score, 14 Handoff communication, 190 Intracerebral hemorrhage outcomes project (ICHOP) Handoff mnemonics, 193 scores, 21 Handoffs and Transitions in Critical Care (HATRICC) Intracranial expansion score, 29 prospective study, 191 Intracranial hemorrhage (ICH) score, 29 Helsinki computerized tomography score chart, 25, 32 Intracranial hemorrhage-related coma with ventricular Hemi-cord syndrome, 142 hemorrhage and dilatation, 97 Hemiparesis, 81 Intra-observer reliability, 14 Hemiplegia, 177 Intrinsic brainstem syndrome, 92 Hemispheric stroke, 97 Ischemic stroke, 97, 98 Hemorrhage after thrombolysis (HAT), 21 Hemorrhagic contusions, 8 Herniation, 83 J Higher-order cortex-motor dissociation (HMD), 115, 115 Jaw weakness, 157 Hijdra grading system, 23, 24 JFK coma recovery (CRS) scale, 19, 27 Horizontal deviation, 111 Jolly test, 157 Horizontal responsiveness to oculovestibular testing, 111 Hughes functional grading scale, 31 Hyperactive delirium, 103, 105, 196 K Hyperammonemia, 79 Kayser–feischer rings, 63 Hyperammonemic encephalopathy, 79 Kernohan’s notch injury, 83 Hypercapnia, 159, 162 Kernohan–woltman syndrome, 83 Hyperkinetic movement disorders, 57, 63 Hyperkinetic symptoms, 60 Hypermagnesemia, 79 L Hyperosmolar hyperglycemia, 77 Lance–adams syndrome, 62 Hypoactive delirium, 103–105, 196 Language performance, 177 Index 209

Late-onset Pompe disease (LOPD), 167 Muscle weakness, 157 Lateral brainstem-displacement syndromes, 92 Myasthenia gravis, 8, 163 Lateral-brain tissue shift, 91 Myasthenia gravis-based muscle weakness, 8 Lateralized periodic discharges (LPDs), 90 Myasthenia gravis composite score, 30 Left ventricular hypertrophy, 167 Myasthenic crisis, 157, 158 Limb girdle muscular dystrophies (LGMD), 167 Mydriasis from inhaled vasodilator, 76 Lipophilic drugs, 72 Myoclonic status epilepticus, 62, 63 Lithium intoxication, 63 Myoclonus, 60–63, 61, 66 Localization eponyms, 54, 54 Myokemias, 156 Localization templates, 40 Locked-in syndrome, 195 Lorazepam, 73 N Low-pressure headache, 3 Nailbed compression, 114 National institute on disability, independent living, and rehabilitation research, 113 M Neck-fexion weakness, 157 Marcus-gunn pupil, 48 Nerve conduction testing (NCV), 153 Marked dysphagia, 62 Neuro intensive care unit, 8 Marshall computerized tomography classifcation, 25, 31 Neurobehavior rating scale-revised, 19 Mastoid bruise (ecchymosis), 37 Neurocritical care, 189, 200 Mechanical failure, 167 Neurocritical disorders, 4, 6 Mechanical respiratory failure, 159 Neurocritical illness, 4, 5, 178 Mechanical ventilation, 163 Neurodegenerative disease, 195 Medical care of neurologic patients, 100 Neuroimaging scales and scores, 23, 24, 24, 25 Medical research council muscle power scale, 30 Neurointensive care experience and practice, 36 Medication-induced mydriasis, 76 Neuroleptic malignant syndrome (NMS), 65 Medication reconciliation, 3 Neuroleptics, 65 Medulla oblongata lesion, 82 Neurologic community, 172 Mesencephalic-pontine injury, 59 Neurologic defcit, 177 Metabolic encephalopathy, 103 Neurologic examination, 36–38, 38 Metronidazole, 76 Neurologic fndings with toxins, 80, 80 Metronidazole-associated encephalopathy, 76 Neurologic movement disorder, 59 Midazolam, 73 Neurologic prognostication, 172, 173 Middle cerebral artery neurological score, 20 Neurology, 35, 43 Middle cerebral artery syndrome, 39 Neuromuscular diseases and scales, 22, 23 Minimally conscious state (MCS), 114, 115 Neuromuscular junction blockers (NMB), 74 Minor traumatic brain injury, 94 Neuromuscular respiratory failure, 3, 161 Misinformation, 191, 192 Neuromuscular unit of respiration, 159, 160 Mitochondrial encephalomyopathy with lactic acidosis Neuronal ischemia, 77 and stroke-like events (MELAS), 155 Neuropathies Modern intensive-care practice, 36 immune-mediated, 155 Modifed fsher scale, 31 loss of sensation, 157 Modifed national institutes of health stroke scale, 28 Neurophobia, 36 modifed Rankin scale (mRS), 176, 176 Neurorehabilitation specialists, 199 Monitoring of agitation in ICU, 107, 107 Neuroresuscitation, 178 Monocular blindness, 52 Nitric-oxide-induced mydriasis, 76 Monocular diplopia, 51 NMDA oropharyngeal dystonia and dystonic Monocular vision loss, 52 posturing, 64, 64 Motor defcit and sphincter dysfunction, 149 Nonconvulsive seizures or seizures, 90 Motor neuron disease, 156 Noninvasive ventilation, 163 Motor responses, 48, 49, 49 Non-neurologic causes of deterioration, 99, 99 change, 7 Nonverbal auditory agnosia, 42 to nail bed/temporomandibular compression, 114 Nursing home care, 198 to noxious stimuli, 35, 127 Motor-system testing, 111 Motor unit and neuromuscular junction, 154, 154 O Movement disorder, 57, 67 Occipital infarcts, 7 Movement disorder mimickers, 58 Occipital lobe masses, 43 Muscle atrophy, 155 Occluded vertebrobasilar arteries, 6 Muscle-specifc tyrosine kinase (MuSK) antibodies, 159 Ocular movements, 126 210 Index

Ocular ultrasonography of optic-nerve sheath, 111 Primitive chewing movements, 114 Oculobulbar facial respiratory (OBFR) score, 22 Primitive refexes, 51, 112 Oculocephalic refex, 111, 126 Probabilistic models, 19 Oculogyric crises, 63 Prognostication, 171 Oculomotor palsy, 51, 52 Progressive brainstem compression, 98 Oculovestibular refex, 48 Progressive encephalopathy, 10 Oculovestibular testing, 111 Psychogenic unresponsiveness, 195 Olivopontocerebellar atrophy, 66 Ptosis, 157 Ophthalmoparesis, 157 Pulmonary function tests, 162 Oral trail-making test, 108 Pulmonary mechanisms with diaphragmatic paralysis, Organ donation using cardiac/circulatory death (DCD) 161, 161 protocol, 132 Pulse oximeter, 162 Organ procurement, 135 Pulseless electrical activity (PEA) arrest, 10 Orienting macro localization, 39–42 Pupilometers, 45 Oropharyngeal muscle weakness, 161 Oscillopsia, 53 Outcome measures in rehabilitation, 19 Q Oxygen desaturation, 129 Quadriplegia, 149 Oxygen-diffusion method, 130, 133 Quantitative myasthenia gravis Score (QMG), 22 Oxyhemoglobin-dissociation curve, 128 Quiet delirium, 104, 105

P R Paralysis, 88 Rapid-response team (RRT) calls, 193 Parietal lobe masses, 42 Rebleeding and acute hydrocephalus, 7 Parkinson’s disease, 195 Recovery after spinal cord infarction, 185 Parkinsonism, 62 Refex hammer, 50 Parkinsonism-associated hydrocephalus, 66 Rehabilitation trajectory after TBI, 179 Paroxysmal/sustained hypertension, 164–165 Renal impairment, 76 Paroxysmal sympathetic hyperactivity, 64–65, 95 Representativeness restraint, 3 Passy-Muir valve placement, 185 Respiratory acidosis, 123 Patient handoff loaded with irrelevancies, 190 Respiratory failure, 100, 159, 163 Perilesional language networks, 177 Respiratory muscle-force examination, 162 Peripheral nerve injury, 156 Resting eye positions, 44, 44 Peripheral neuropathies, 154 Restlessness, 196 Peripheral vestibular and congenital nystagmus, 53 Retinal and vitreous hemorrhages, 111 Permanent brain injury, 98 Reversing opioids, 75 Persistent autonomic state, 112 Rhabdomyolysis, 6, 62, 66 Persistent vegetative state (PVS), 112 Rhythm disorders, 166 Pharmacokinetic changes, 72 Rhythmical jerking movements, 6 Pharyngeal refexes, 111 Right hemisphere language network, 177 Physiologic global brain dysfunction, 116 Rocuronium, 74 Ping-pong eye movements, 110, 110 Romberg test, 50 Plasma osmolality, 78 Rostral brainstem infarction, 7 Polyneuropathies, 154 Rotterdam Computerized Tomography Score, 25, 31 Positional nystagmus, 54 Posterior circulation syndromes, 42 Posterior fossa mass lesions, 59 S Posterior reversible encephalopathy syndrome, 165 Safe implementation of treatments in stroke symptomatic Posterolateral column syndrome, 147 intracerebral hemorrhage (SITS-ICH), 21 Post-thrombolysis risk score (PRS), 21 SARS-CoV-2 viruses, 156 Post-traumatic PVS, 112 Scoring systems, 14 Posturing Por intermittent spasmodic stiffness, 58 Seizures, 90, 195 Praxis and behaviour, 42, 43, 43 Self-extubation, 74 Predicting hematoma growth and outcome in Sensation tests, 157 intracerebral hemorrhage using contrast bolus Sensory dermatomes, 143, 144 computed tomography (PREDICT) score, 21 Sensory loss patterns, 143, 145 Predictive Swallowing Score (PRESS), 178 Serotonin syndrome, 65, 66, 66 Preserved autonomic and brainstem functions, 112 Severe traumatic brain injury, 7 Pressure-induced muscle necrosis, 6 Single breath-count test, 161 Index 211

Sinus tachycardia, 166, 166 Thunderclap headache, 4 Situation-Background-Assessment-Recommendation Titin gene mutations, 155 (SBAR) model, 191 Tonic deviation of the eyes, 111 Skew deviation, 52 Toxidromes, 79, 108 Sleep–wake cycles, 114 Training programs, brain-death determination, 133 Small-fber neuropathy, 155 Traumatic brain injury (TBI), 8, 19, 20, 179 Social phobia inventory (SPIN) score, 20 Traumatic head injury, improvement in, 180 Speech and language, 43, 43, 44 Traumatic spinal cord injury, 8 Speech therapy, 177 Tremor, 60, 61 Spetzler–martin grading system, 21 Trismus, 63, 64 Spinal cord, anatomy, 140, 141, 141 Trusting faulty memory, 2 Spinal cord compression, 139, 147, 148 Spinal cord injury assessment, 149 Spinal epidural abscess, 148 U Spinothalamic tract, 140 Uncontrolled agitation, 4 Spontaneous eye movements, 89, 110 Unexplained respiratory failure, 10 Static posture, 50 Unresponsiveness, 195 Status dystonicus, 63–64 Untreated hydrocephalus, 175 Status myoclonus, 182 Stimulation-induced movements, 112 Stress cardiomyopathy, 100, 164, 166 V Stroke prognostication using age and NIH stroke Vagal spells, 166 scale-100 (SPAN-100), 21 Vague descriptions, 199 Stroke scales and scores, 20–22 Vascular territories, 41 Stroke syndrome, 181 Vasovagal collapse, 2 Stroke-thrombolytic predictive instrument Ventilator auto-cycling, 123, 124 (Stroke-TPI,), 21 Ventilatory assistance in acute neuromuscular respiratory Subacute subdural hematoma, 95 failure, 154 Succinylcholine, 74 Vermicular twitching resembling fasciculations, 127 Sulfamethoxazole-trimethoprim, 76 Vertical visual tracking, 45 Superfcial sensation, 49 Vertical writing with eyes closed, 54 Supportive care, 176 Vibration splitting, 149 Sympathetic storms, 65 Visual diffculties, due to cranial nerve Syndromic patterns in deteriorating patients, 91, 91 involvement, 179 Synthetic opioids, 80 Visual orienting refex, 113 Visuospatial function, 49 Volatile substance-abuse problem, 80 T Tandem gait walking, 50 Targeted temperature management (TTM), 122 W Temporal lobe masses, 42 Wallenberg syndrome, 54, 54 Tendon refexes, 158, 158 Waxing and waning, 105 Tetanic cramps and myoclonus, 80 Weaning from mechanical ventilation, 163, 164 Tetanus-like seizures, 58 Word repetition, 44 Tetraplegia, 149 World federation of neurological surgeons (WFNS), 30 Thalamic compression, 92 Thalamic infarctions, 42 Thoraco-abdominal asynchrony, 161 Z Thrombolysis in cerebral infarction (TICI) score, Zika viruses, 156 24, 25, 31