Bulbar brain syndrome

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The Bulbärhirnsyndrom means the symptom complex that results from loss of brain stem functions, and is usually the result of the mid-brain syndrome . The bulb brain is a functional level of the brain stem .

Symptoms

The symptom complex is often divided into two stages.

  • Stage 1: is characterized by deep unconsciousness, a lack of spontaneous movements and pain reactions, decreasing muscle tone, increasing pupil dilation and irregular breathing.
  • Stage 2: Stage 2 with a lack of muscle tone, lack of reflexes, maximum pupillary dilation and respiratory arrest quickly leads to brain death.

Both stages are not easy to separate from each other, so that some characteristics are only described generally:

  • Failure of all brain stem functions
  • atactic breathing to gasping (until breathing has stopped)
  • deep coma
  • flaccid muscle tone all over; Muscles are hypotonic
  • dilated and rigid pupils, extinction of the corneal reflex, divergent position of the eyeballs

Acute Bulbar Brain Syndrome

An acute (traumatic) bulbar brain syndrome usually occurs with severe bilateral damage to the deeper brainstem regions (pons and medulla oblongata) as a result of cerebellar entrapment. The pressure must be relieved within a few minutes.

root cause

The cause is an entrapment of the medulla oblongata by the cerebellar tonsil.

forecast

The Bulbärhirnsyndrom usually takes a fatal outcome, but it is not generally a dismal (poor) prognosis. Regeneration after global brain damage is possible up to the level of the bulbar brain syndrome. Patients always reach consciousness through a passage syndrome . A transition from bulbar brain syndrome to brain death , on the other hand, is irreversible.

If they survive, the most massive brain damage usually leaves neurological deficits up to Apallic syndrome .

Individual evidence

  1. ^ Klaus Poeck, Werner Hacke: Neurology: For study, clinic and practice . 12., act. u. exp. Edition. Springer, Berlin / Heidelberg 2006, ISBN 3-540-29997-1 , p. 100.
  2. ^ Hugo Van Aken, Konrad Reinhart, Michael Zimpfer, Tobias Welte: Intensive Care Medicine . 2., revised. Edition. Thieme, Stuttgart 2006, ISBN 3-13-114872-1 , p. 219.
  3. ^ Karl F. Masuhr, Marianne Neumann: Neurology . Thieme, Stuttgart 2007, ISBN 978-3-13-135946-9 , p. 370.
  4. ^ Walter Gehlen, Heinz-Walter Delank: Neurology . 12th, completely revised edition. Thieme, Stuttgart 2010, ISBN 978-3-13-129772-3 , p. 134.
  5. ^ Jörg Rüdiger Siewert, Hubert J. Stein, Martin Allgöwer: Chirurgie. 9th edition. Springer, 2012, ISBN 978-3-642-11330-7 , p. 200.
  6. ^ Franz-Josef Kretz, Jürgen Schäffer: Anesthesia, intensive care medicine, emergency medicine, pain therapy . 5., corr. u. edit again Edition. Springer, Berlin / Heidelberg 2008, ISBN 978-3-540-75572-2 , p. 348/349.

literature

  • Kersten Enke, Andreas Flemming, Hans-Peter Hündorf, Peer G. Knacke, Roland Lipp, Peter Rupp: LPN 3 textbook for preclinical emergency medicine. Volume 3: Focus on traumatology . 4th edition. Stumpf & Kossendey Verlag, Edewecht 2009, ISBN 978-3-938179-70-3 , pp. 65-66 .

Web links