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Hypertensive encephalopathy (HE) is general brain dysfunction due to significantly high blood pressure. [3] Symptoms may include headache, vomiting, trouble with balance, and confusion. [1] Onset is generally sudden. [1] Complications can include seizures, posterior reversible encephalopathy syndrome, and bleeding in the back of the eye. [1] [3]
Exposure to drugs (e.g. alcohol) or toxins may also lower LOC, [3] as may a core temperature that is too high or too low (hyperthermia or hypothermia). Increases in intracranial pressure (the pressure within the skull) can also cause altered LOC. It can result from traumatic brain injury such as concussion. [12]
As mentioned, cholelithiasis is the most common cause of hyperbilirubinemia. Gallstones can be removed using acid or shock waves in litholytic therapy and lithotripsy, respectively. Alternatively, cholecystectomy can remove the gallbladder directly. [34] Once obstruction from the biliary tree is removed, normal bilirubin elimination should resume.
The prothrombin time ratio is the ratio of a subject's measured prothrombin time (in seconds) to the normal laboratory reference PT. The PT ratio varies depending on the specific reagents used, and has been replaced by the INR. [3] Elevated INR may be useful as a rapid and inexpensive diagnostic of infection in people with COVID-19. [4]
The diagnosis of hepatic encephalopathy is a clinical one, once other causes for confusion or coma have been excluded; no test fully diagnoses or excludes it. Serum ammonia levels are elevated in 90% of people, but not all hyperammonaemia (high ammonia levels in the blood) is associated with encephalopathy.
Delirium (formerly acute confusional state, an ambiguous term which is now discouraged) [1] is a specific state of acute confusion attributable to the direct physiological consequence of a medical condition, effects of a psychoactive substance, or multiple causes, which usually develops over the course of hours to days.
The most common cause is due to acquired hypercoagulability associated with myeloproliferative disorders (accounting for 40–50% of cases). [ 13 ] [ 2 ] Other acquired hypercoagulable disorders that may result in Budd–Chiari syndrome include antiphospholipid syndrome and paroxysmal nocturnal hemoglobinuria , which are responsible for 10–12 ...
Less common causes include snake bites, frostbite, and burns. [1] There are two main types: acute (rapid onset) and chronic (slow onset). [1] Diagnosis is typically based on blood tests. [2] Findings may include low platelets, low fibrinogen, high INR, or high D-dimer. [2] Treatment is mainly directed towards the underlying condition.