About the Book

• Student-friendly approach is used.
• Assists the nurses in providing excellent care to patients with neurological and neurosurgical conditions.
• Provides in-depth information in a very simple language.
• All the chapters are systematically organised into 21 sections consisting of 177 chapters.
• Includes neuroanatomy, assessment, diagnostic evaluation and management of neurological disorders.
• Well-explained, illustrated with diagrams and tables for better understanding.
• Covers entire syllabus of neuroscience nursing as per the Indian Nursing Council (INC).
• Essential textbook for nursing students of GNM, PB BSc (N), Basic BSc (N) and MSc (N) and also to staff nurses working in neuromedical and surgical units.

About the Author

Clement I MA (Sociology) MA (Child Care and Education) MSc (Nursing) PG Diploma in Hospital Administration

Table of Contents:
Section 1 ? Introduction to Neuroscience Nursing 1. Historical Development in Neuroscience Nursing Historical Perspectives of Neuroscience Nursing 3 Neuroscience Nursing Organizations 4 History of Neuronursing in Some Important Nations 4 Clinical Role of Neuroscience Nurse 6 Scope of Neuroscience Nursing 7 Characteristics of Neuroscience Nursing 8 Nursing Process Application in Neuroscience Nursing 8 2. Emerging Trends and Issues in Neuroscience Nursing Technological Advancement 11 Research in Neurosciences 12 Neurotrauma-related Issues 12 Neuroscience Nursing Practice 13 Role of Nurse in Neuroscience Nursing 13 3. Standards of Neuroscience Nursing Practice Responsibilities of Advanced Practice Nurse 15 Standards of Advanced Neuronursing Practice 15 Professional Standards in Neuronursing 17 4. Neuroethics Ethics in Nursing 20 History of Neuroethics 21 Ethics in Neuroscience 21 Therapeutic Interventions 22 Code of Ethics 22 Ethical Dilemma 23 Ethical Principles in Nursing Practice 23 Ethical Principles for Nurses 24 5. Neurogenetics History of Neurogenetics 26 Advancement in Neurogenetics 26 Neurogenetic Disorders 27 Section 2 ? Review of Neuroanatomy and Physiology 6. Embryology of Central Nervous System Embryological Development 36 7. Cells of the Nervous System Neuroglial Cells 38 Neuromuscular Junction 41 Neural Impulse 41 Neurotransmitters 42 Important Neurotransmitters 43 Contentsxii Textbook on Neurological and Neurosurgical Nursing 8. Cranial and Spinal Bones Skull 45 Vertebral Column 45 9. Meninges of the Brain and Spinal Cord Meninges 47 Applied Anatomy 47 10. Ventricles of the Brain Ventricles 49 Ventriculography 49 Choroid Plexuses 49 Applied Anatomy 51 11. Brain (Encephalon) Cerebrum 52 Barrier System in the Brain 57 Functions of the Human Brain 58 12. Gray Matter of Cerebrum/Diencephalon (Forebrain) Diencephalon 59 Thalamus 59 Hypothalamus 60 Basal Nuclei/Ganglia 61 13. White Matter of Cerebrum Myelinated Fibers 63 Corpus Callosum 63 Internal Capsule 65 Applied Anatomy 65 14. Brainstem (Mesencephalon) Midbrain 66 Pons 67 Medulla Oblongata 68 Features of Brainstem Lesions 68 15. Cerebellum Cerebellum 70 16. Spinal Cord External Features 73 Internal Features 73 Physiology of Reflex Action 75 Tracts of Spinal Cord 75 Applied Anatomy 77 Applied Physiology 78 Study of Spinal Cord 78 17. Cranial Nerves Olfactory Nerve 79 Optic Nerve 80 Oculomotor 82Contents xiii Trochlear Nerve 83 Trigeminal Nerve 84 Abducens Nerve 85 Facial Nerve 85 Vestibulocochlear Nerve 88 Glossopharyngeal Nerve 88 Vagus Nerve 89 Accessory Nerve 90 Hypoglossal Nerve 90 Nervus Terminalis 91 18. Nerve Plexuses Cervical Plexus 92 Brachial Plexus 92 Lumbar Plexus 94 Sacral Plexus 95 19. Autonomic Nervous System Subdivisions of ANS 97 Functions of Sympathetic and Parasympathetic Divisions 98 Applied Anatomy 98 Section 3 ? Neuroscience Investigation 20. Skull and Spinal X-ray Purposes 104 General Instructions 104 Client Preparation 104 Procedure 104 Aftercare 104 21. Computed Tomography Indications 105 Purposes 105 Preparation of the Client 105 Preparation of the Environment 106 Procedure 106 Complications 107 Advantages 107 Nurses’ Responsibility 107 22. Magnetic Resonance Imaging Purposes 108 Principles 108 General Instructions 109 Preparation 109 Procedure 109 Advantages and Disadvantages 109 Contraindications 110 Nursing Care 110xiv Textbook on Neurological and Neurosurgical Nursing 23. Positron Emission Tomography Purposes 111 Principles of PET 111 General Instructions 112 Preparation of the Client 112 Procedure 112 Advantages and Disadvantages 112 Nurses’ Role 112 24. Electroencephalography Purposes 113 Indications 113 Wave Patterns in Electroencephalography 113 General Instructions 113 Client Preparation 114 Procedures 114 25. Glasgow Coma Scale Purposes 116 General Instructions 116 Client Preparation 116 Procedure 116 Pediatric Coma Scale 118 Explanatory Notes on the Pediatric Coma Scale 118 Neurological Observation in Children Under 5 Years of Age 119 26. Doppler Imaging Indications 121 Purposes 121 Advantages 121 Types 121 Preparation 121 Procedure 122 27. Evoked Potentials Purposes 123 Indications 123 Types of Evoked Potentials 123 Advantages 123 Client Preparation 123 Procedure 124 28. Echoencephalography Reference Values 125 Indications for Echoencephalography 125 Client Preparations 125 Procedure 125 29. Lumbar Puncture Purposes 126 Indications 126 General Instructions 127Contents xv Preparation 127 Procedure 127 Complications 128 Nurses’ Responsibility 129 30. Myelography Purposes 130 Indications 130 General Instructions 130 Client Preparation 130 Procedure 130 Nurses’ Responsibility 131 31. Electromyography Indications 132 Purposes 132 Client Preparation 132 Procedure 132 32. Cerebral Angiography Indications 134 Purposes 134 General Instructions 134 Client Preparation 134 Procedure 135 Complications 135 Contraindications 135 Nurses’ Responsibility 135 33. Digital Subtraction Angiography Purposes 137 Indications 137 Instructions 137 Client Preparation 137 Procedure 138 Disadvantages 138 34. Cisternal Puncture Purposes 139 Client Preparation 139 Procedure 139 35. Caloric Testing......... Instructions 140 Patient Preparation 140 Procedure 140 Interpretation 141 36. Tensilon (Edrophonium Chloride) Test Purpose 142 Equipment 142 Client Preparation 142 Procedure 142xvi Textbook on Neurological and Neurosurgical Nursing 37. Intracranial Pressure Monitoring Indications 144 Classification 144 General Instructions 144 Client and Environment Preparation 145 Procedure 145 38. Cerebral Blood Flow Monitoring Indications 147 Client and Environment Preparation 147 Procedure 148 39. Cerebrospinal Fluid Flow Monitoring Reference Values 149 Interfering Factors 149 Indications and Contraindications 149 Procedure 149 Lateral C1–C2 Puncture 150 Ventricular Puncture 150 Nerve Conduction Velocity Studies 151 40. Biopsy—Muscle, Nerve and Brain Muscle and Nerve Biopsy 152 Brain Biopsy 152 41. Hearing Test Whisper and Conversation Tests 154 Tuning Fork Tests 154 Section 4 ? Neuropharmacology 42. Neurological Drugs and Nurses’ Responsibilities Patient Education 159 Important Neurological Drugs 159 43. Opium Derivatives Opium 160 Medications 160 Interventions for Opioid Analgesics 161 Morphine 161 Synthetic Substitutes of Morphine 163 44. Narcotic Antagonists Classifications 165 Interventions 166 45. Non-opioid Analgesics Non-steroidal Anti-inflammatory Drugs 167 Acetaminophen (Tylenol) 167 46. Hypnotics Organic Hypnotics 169Contents xvii 47. Barbiturates Classification 170 Effects 170 Uses 170 Toxicity 170 Contraindications 171 Treatment 171 Phenobarbitone 171 Intravenous Barbiturates (Ultrashort Barbiturates) 171 48. Non-barbiturate Hypnotics Important Non-barbiturate Hypnotics 173 Methaqualone (Melsedin) 173 Flurazepam 173 Thalidomide 173 49. Alcohol Actions of Alcohol 174 Advantage 174 Disadvantage 174 Uses 174 Contraindications 175 Treatment of Chronic Alcoholism 175 50. Antiepileptic Drugs Classification 176 Barbiturates 176 Primidone 177 Hydantoin Derivatives (Diphenylhydantoin Phenytoin) 177 Phenytoin Sodium (Dilantin) 177 Mesantoin 178 Oxazolidinedione (Trimethadione) 178 Succinimides 178 Acetylureas 178 Aminoglutethimide (Cytadren) 178 Acetazolamide (Diamox) 178 Sulthiame (Ospolot) 179 Diazepam (Valium) 179 Clonazepam (Klonopin) 179 Nitrazepam 179 Carbamazepine (Tegretol) 179 Sodium Valproate 179 51. Antipyretics Salicylates 180 Acid Acetylsalicylic (Aspirin) 180 Phenacetin 181 Aspirin Phenacetin Combination 181 Paracetamol 181 Dextropropoxyphene 181 Phenylbutazone 181xviii Textbook on Neurological and Neurosurgical Nursing Oxyphenbutazone (Suganril) 181 Indomethacin 182 Whitfield’s Ointment 182 52. Analgesics Classification 183 53. Drugs Used in Rheumatoid Arthritis Management 184 Classification 184 Mode of Action of Non-steroid Anti-inflammatory Drugs 184 Anti-inflammatory Drugs 184 Corticosteroids 185 Cytotoxic Drugs 185 54. Antiparkinsonian Agents Treatment 187 55. Analeptics Classification 189 Uses 189 56. Antimyasthenic Medications........ Interventions 191 Tensilon Test 191 57. Osmotic Diuretics Side Effects 192 Interventions 192 Section 5 ? Neurological Manifestations 58. Migraine Causes 195 Mechanisms 195 Classical Migraine 195 Types 196 Treatment 196 Management 197 59. Vertigo Physiology 199 Causes of Vertigo 199 Investigations 200 Treatment 200 60. Aphasia Anatomy and Physiology of Speech 202 Classifications 202 Assessment of Aphasic Patients 203 Diagnosis 203 Management 204 Nursing Management 204 Nursing Interventions 204Contents xix 61. Ataxia Causes 206 Types 207 Clinical Manifestations 208 Diagnostic Evaluation 209 Management 209 62. Dysarthrias (Disorder of Speech) Causes 211 Types and Causes 211 Examination of Speech 212 Clinical Manifestations 212 Management 212 63. Dysphonia/Aphonia Causes 213 64. Concussion Causes 214 Clinical Manifestations 214 Complications 215 First Aid for Concussion 215 Management 216 65. Paralysis Important Paralytic Diseases 217 Causes 217 Clinical Manifestations 217 Types of Paralysis 217 Diagnosis 217 Management 218 Complications 218 66. Hemiplegia Nursing Management 219 67. Quadriplegia Causes 221 Spinal Nerves and Levels 222 Symptoms of Quadriplegia 223 Management 224 Complications of Quadriplegia 224 68. Paraplegia Causes 225 Clinical Manifestations 225 Diagnostic Evaluation 226 Assessment 226 Nursing Intervention and Goals 226 Rehabilitation 228 Health Education 228xx Textbook on Neurological and Neurosurgical Nursing 69. Sensory Impairment Conduction of Sensory Afferent Impulses 229 Localization of ‘Lesion of Disturbances’ of Sensation 230 Sensory Disorders 232 70. Visual Disturbances Common Visual Symptoms 235 Examination of Visual Defects 237 Patterns of Visual Field Loss 237 Optic Nerve Lesions 237 Tumors of the Optic Nerve 237 71. Cerebral Compression Causes 239 Symptoms 239 Cerebral Concussion 239 Cerebral Contusion 239 72. Nystagmus Causes 241 Degrees of Nystagmus 241 Types of Nystagmus 241 73. Disorders of Motor Function and Equilibrium Disorders of Motor Function 243 Disorders of Equilibrium 244 74. Abnormal Movements Myoclonus 246 Opisthotonus 246 Chorea 247 Dystonia 247 Ballism 248 Tremors 248 Tics 249 Involuntary Movements of Face and Neck 250 Movements Limited to Muscles 250 75. Spinal Reflexes Myotatic or Stretch Reflexes 252 Superficial Reflexes 252 76. Pupillary Disorders Parasympathetic and Sympathetic Pathways 254 Pupillary Abnormalities 254 77. Gait and Gait Disturbances Gait Cycle 256 Pathological Gaits 258 Gait Training 260 78. Rigidity and Back Pain Muscle Tone Disorder (Rigidity) 262 Back Pain 262Contents xxi 79. Spasticity Pathophysiology 265 Classification of Spasticity 265 Effects of Spasticity 265 Clinical Evaluation 266 Management 266 Principles 266 Pharmacology in Treatment of Spasticity 267 Section 6 ? Neurological Examination and Assessment 80. Introduction to Neurological Examination Neurophysical Examination 271 Purposes 271 Instruments Used 271 Neuroexamination Tools 273 History Collection 275 81. Assessment of Conscious Levels and Higher Cerebral Function Conscious Level Assessment 279 Examination of Higher Cerebral Function 280 82. Cranial Nerve ExaminationOlfactory Nerve 282 Optic Nerve 282 Oculomotor, Trochlear and Abducens 284 Trigeminal Nerve 285 Facial Nerve 287 Acoustic/Auditory Nerve 287 Glossopharyngeal and Vagus Nerve 288 Spinal Accessory Nerve 289 Hypoglossal Nerve 290 83. Neurological Examination of Different Body Parts Examination of Motor Status 291 Examination of Upper Limbs 292 Examination of Sensation 292 Examination of Upper Limb Reflexes 297 Examination of Lower Limb Motor System 300 Assessing Deep Tendon and Plantar Reflexes 300 Examination of Coordination 305 Examination of Posture and Gait 305 Section 7 ? Neurodevelopmental Disorders 84. Neurological Anomalies Etiology 309 Types 309 Assessment Findings 309 Spina Bifida 309xxii Textbook on Neurological and Neurosurgical Nursing Anencephaly 313 Encephalocele 313 Microcephalus 313 85. Meningomyelocele Types of Meningomyelocele 314 Pathophysiology 314 Clinical Features 314 Diagnostic Evaluation 315 Management 315 86. Hydrocephalus Cerebrospinal Fluid Circulation Pathway 317 Etiology of Hydrocephalus 317 Classifications 318 Pathophysiology 318 Clinical Manifestations 318 Diagnostic Evaluation 319 Management 319 Nursing Management 321 Complications 322 Prognosis 322 87. Syringomyelia Incidence 323 Etiology 323 Clinical Manifestations 323 Diagnostic Evaluation 324 Management 324 Surgery 324 Nursing Management 325 Complications 325 88. Chiari Malformation History 326 Classifications 326 Causes 326 Clinical Manifestations 327 Diagnostic Evaluation 327 Medical Management 328 89. Microcephaly Causes of Microcephaly 329 Clinical Manifestations 329 Diagnostic Evaluation 329 Management 330 90. Anencephaly Causes 331 Clinical Manifestations 331 Diagnostic Evaluation 331 Management and Counseling 332Contents xxiii 91. Craniosynostosis Causes 333 Types 333 Clinical Manifestations 334 Diagnostic Evaluation 334 Treatment 335 Complications 335 Prevention and Counseling 335 92. Down Syndrome (Mongolism) Types 336 Clinical Manifestations 336 Physical Characteristics 336 Diagnostic Evaluation 337 Management 337 Counseling 337 Prognosis 337 93. Mental Retardation Classification 338 Etiology 338 Clinical Manifestations 339 Diagnostic Evaluation 339 Management 339 Preventive Measures 340 94. Cerebral Palsy Etiology 341 Recognition of Cerebral Palsy 341 Communication Difficulties 342 Types 343 Pattern of Involvement in Cerebral Palsy 344 Management 344 Principles of Corrective Positioning in Cerebral Palsy 346 Contractures in Cerebral Palsy 349 Activities of Daily Living in Cerebral Palsy 350 Section 8 ? Injury to Brain and Spinal Cord 95. Head Injury Etiology 357 Pathophysiology 357 Clinical Manifestation 358 Effects of Brain Injuries 360 Clinical Approach of a Patient with Head Injury 361 Diagnostic Evaluation 362 Management 362 Complications of Head Injury 362 Nursing Management During Emergency 364 Nursing Process 364 Brain Herniation 366xxiv Textbook on Neurological and Neurosurgical Nursing 96. Spinal Cord Injury Etiology 370 Mechanism of Injury 370 Types of Spinal Cord Damage 371 Spinal Cord Syndrome 372 Pathophysiology 372 Spinal Shock 373 Clinical Manifestations 373 Management 374 Emergency Management 374 Nursing Intervention 376 Health Education 376 Section 9 ? Neuroinfections 97. Meningitis Etiology 381 Route of Entry 381 Pathophysiology 381 Clinical Manifestations 382 Complications 382 Diagnostic Evaluation 382 Management 383 Types of Meningitis 383 98. Encephalitis .. Etiology 386 Pathophysiology 387 Clinical Manifestations 387 Diagnostic Evaluation 387 Management 387 Complications 388 Nursing Management 388 99. Brain Abscess Etiology 390 Clinical Manifestations 390 Diagnostic Evaluation 390 Management 390 Nursing Management 391 100. Neurosyphilis Pathophysiology 392 Clinical Manifestations 392 Symptoms 393 Diagnostic Evaluation 393 Management 393 Nursing Management 393Contents xxv 101. HIV and Neurological Manifestations Sources of Infection 394 HIV Transmission 394 Pathophysiology 395 Clinical Manifestations 395 Neurological Manifestations 396 Diagnostic Evaluation 396 Management 397 Prevention of Transmission 397 102. Neurocysticercosis Epidemiology 398 Pathogenesis 398 Clinical Manifestations 399 Diagnostic Evaluation 399 Management 400 Prevention 400 Complications 400 103. Intracranial Tuberculosis Incidence 401 Tuberculou Meningitis 401 Nursing Management 403 104. Cerebral Malaria Etiology 405 Disease Specific Severity Scales 406 Pathogenesis 406 Clinical Manifestations 407 Management 407 Section 10 ? Care of Neurological Conditions 105. Altered Level of Consciousness Components of Consciousness 411 Etiology 412 Pathophysiology 412 Clinical Manifestations 413 Diagnostic Evaluation 413 Nursing Assessment 414 Nursing Diagnosis 414 Objectives 415 Nursing Interventions 415 106. Increased Intracranial Pressure Etiology 417 Pathophysiology 417 Clinical Manifestations 418 Diagnostic Evaluation 419 Management 419xxvi Textbook on Neurological and Neurosurgical Nursing 107. Intervertebral Disk Prolapses Clinical Manifestations 421 Management 421 Complications 422 108. Low Back Pain Causes of Low Back Pain 423 Factors, Which Increases Low Back Pain 423 Clinical Manifestations 424 Treatment 424 109. PainTypes 426 Acute Pain 427 Pain Theories 428 Factors Influencing Pain 429 Nursing Management 430 Alleviation of Pain: Non-invasive Pain Relief Measures 432 Pain Management 433 110. Neurological Disturbances of Bladder Classification 434 Etiology 435 Types of Bladder Disturbances 435 Diagnostic Evaluation 436 Management 436 Section 11 ? Cerebrovascular Disorder 111. Cerebrovascular Accident/Stroke Incidence 441 Etiology 441 Pathophysiology 442 Factors Influencing Cerebral Blood Flow 442 Clinical Manifestations 442 Common Symptoms 444 Diagnostic Evaluation 445 Emergency Management 446 Surgical Management 446 Complications of Stroke 447 Nursing Responsibilities and Interventions 447 Compensatory for Sensory-perceptual Deficits 449 Restoring Continence 449 Promoting Effective Coping 450 Transferring to Wheelchair 450 112. Transient Ischemic Attacks Incidence 451 Causes 451 Risk Factors 451Contents xxvii Clinical Manifestations 452 Warning Signs 453 Diagnostic Evaluation 453 Treatment 454 Management 454 Prevention 454 113. Cerebral Aneurysm Incidence 455 Etiology of Cerebral Aneurysm 455 Classifications 455 Morphology 456 Location 457 Pathophysiology 457 Clinical Manifestations 457 Diagnostic Evaluation 458 Management of Cerebral Aneurysm 458 Surgical Management 459 Complications 460 Nursing Care of Patient with Cerebral Aneurysm 460 114. Cerebral Arteriovenous Malformation Incidence 462 Causes 462 Pathology 462 Classification and Grading 463 Clinical Manifestations 463 Diagnostic Evaluation 464 Management 464 Surgical Management 464 Complications 464 115. Moyamoya Disease Incidence 465 Etiology 465 Associated Diseases 466 Clinical Manifestations 466 Pathology 466 Diagnostic Evaluation 467 Management 467 Surgical Management 468 Complications 469 Rehabilitation 469 116. Interventional Neuroradiology Embolization 470 Nursing Role Prior, During and Postprocedure 472 Lysis of Thrombotic Materials 474 Dilatation of Stenosis 474xxviii Textbook on Neurological and Neurosurgical Nursing Section 12 ? Paroxysmal Disorders 117. Epilepsy/Seizures Etiology 477 Risk Factors 477 Pathophysiology 477 Classifications 477 Clinical Manifestations 480 Diagnostic Evaluation 480 Management 481 Emergency Management 482 Nursing Interventions 483 Health Education 483 118. Cephalgia/Headache Etiology 484 Pathophysiology 484 Diagnostic Evaluation 485 Physical Examination 486 Diagnosis 486 Assessment of Headache 487 Nursing Diagnosis 487 Nursing Intervention 487 119. Syncope Etiology 489 Diagnostic Evaluation 490 Management 490 Nursing Care Application 490 Section 13 ? Central Nervous System Tumors 120. Cerebral Tumors Types 493 Tumor Grade 494 Diagnostic Evaluation 495 Management 495 Pituitary Adenoma 496 Infratentorial or Posterior Fossa Lesions 496 Cerebral Tumors 496 Preoperative Preparation 496 Surgery 496 Meningioma 497 Gliomas and Metastatic Tumors 497 Postoperative Nursing Care 497 Potential Problems 497 Nursing Management 498 Complications of Surgery 498Contents xxix 121. Intracranial Tumors Classification 500 Pathophysiology 500 Clinical Manifestations 501 Diagnostic Evaluation 501 Management 501 Prognosis 502 122. Pituitary Tumors Etiology 503 Classification 503 Clinical Manifestations 503 Diagnostic Evaluation 504 Surgical Management 505 Nursing Management 505 123. Craniopharyngiomas Clinical Features 506 Investigation 506 Management 506 124. Spinal Cord Tumors Etiology 508 Classifications of Spinal Tumors 508 Diagnostic Evaluation 509 Management 509 Section 14 ? Neurodegenerative Disorders 125. Dementia Causes 513 Classification 513 Clinical Manifestations 514 Dementia Measurement Scale 514 Diagnostic Evaluation 515 Management 516 Complications 517 Nursing Management 517 126. Alzheimer’s Disease Etiology 519 Pathophysiology 519 Clinical Manifestations 520 Diagnostic Evaluation 521 Medical Management 521 Nursing Management 521 127. Parkinson Disease Etiology 523 Pathophysiology 523 Clinical Manifestations 524xxx Textbook on Neurological and Neurosurgical Nursing Diagnostic Evaluation 525 Complications 525 Management 526 Nursing Management 528 128. Guillain-Barré Syndrome Incidence 530 Etiology 530 Pathophysiology 531 Clinical Manifestations 531 Diagnostic Evaluation 532 Complications 532 Management 532 Prognosis 532 Nursing Diagnosis 532 Nursing Interventions 533 Health Education 534 129. Myasthenia Gravis Etiology 535 Pathophysiology 535 Clinical Manifestations 535 Management 536 Nursing Diagnosis 537 Nursing Interventions 537 130. Multiple Sclerosis Etiology 538 Pathophysiology 538 Clinical Manifestations 539 Symptoms 539 Management 539 Nursing Management 540 Drugs Used 540 Patient Education 541 131. Amyotrophic Lateral Sclerosis Etiology 542 Pathophysiology 542 Clinical Manifestations 542 Management 542 132. Huntington’s Disease Incidence 543 Clinical Manifestations 543 Classifications Based on Age Groups 543 Genetics of Huntington’s Disease 543 133. Neurofibromatosis Type 1 Clinical Manifestations 544 Genetic Neurofibromatosis 544 Inheritance Facts of Neurofibromatosis 545Contents xxxi Section 15 ? Cranial Nerve Diseases 134. Trigeminal Neuralgia Anatomy of Trigeminal Nerve 550 Types of Trigeminal Neuralgia 550 Risk Factors 551 Etiology 551 Pathophysiology 551 Clinical Manifestations 551 Diagnostic Evaluation 551 Management 551 Surgical Management 552 Nursing Diagnosis 555 Health Teaching 555 135. Bell’s Palsy Etiology 556 Pathophysiology 556 Clinical Manifestations 556 Diagnosis and Prognosis 556 Treatment 556 Nursing Interventions 557 136. Ménière’s Disease Etiology 558 Pathophysiology 558 Clinical Features 558 Diagnostic Evaluation 558 Variants of Ménière’s Disease 559 Management 559 137. Glossopharyngeal Neuralgia Etiology 560 Clinical Manifestations 560 Diagnostic Evaluation 560 Treatment 560 Surgical Management 561 Nursing Management 562 Complications 562 138. Carpal Tunnel Syndrome Incidence and Risk Factors 563 Causes of Tunnel Syndrome 563 Clinical Manifestations 564 Diagnostic Evaluation 564 Management of Carpal Tunnel Syndrome 564 Complications 565 Preventive Measures 565 Instructions to Patient on Self-care 566xxxii Textbook on Neurological and Neurosurgical Nursing Section 16 ? Neurosurgery 139. Introduction to Neurosurgery Brain Surgery 571 History of Neurosurgery 571 Development of Neurosurgery in India 572 140. Development of Neurosurgical Techniques Surgery for Brain Tumors 573 Cerebrovascular Surgery 574 Surgery for Epilepsy 575 Surgery for Movement Disorders 575 Surgery for Intractable Pain 576 Surgery for Trigeminal Neuralgia 576 Psychosurgery 576 Stereotactic Surgery 576 Endoscopic Neurosurgery 577 Development of High-speed Drills 577 141. Equipments Used for Neurosurgery Neurodiagnosis: Study of Equipments 578 Surgical Equipments 579 142. Perioperative Process in Neurosurgery Perioperative Goals 582 Indications for Neurosurgery 582 Neurosurgical Diseases 582 Neurosurgical Procedures 584 Cerebral Revascularization Surgical Procedure 585 Preoperative Phase 586 Intraoperative Phase 586 Postoperative Phase 588 143. Craniotomy Purposes 590 Methods of Doing Craniotomy 590 Description of the Surgery 590 Diagnostic Evaluation 591 Preoperative Care 591 Intraoperative Care 591 Positioning 591 Postoperative Care 592 Jackson-Pratt Suction Drain 592 Complications of Surgery 592 144. Laminectomy Spinal Decompression 594 Description of Surgery 594 Patient Preparation 595 Postoperative Care 596 Complications 597 Risk of Laminectomy Surgery 145. Stereotactic Radiosurgery History 598 Indications 599 Need 599 Classifications 599 Types of Stereotactic Frame System 600 Different Stereotactic Radiosurgery Systems 600 Side Effects 602 146. Ventriculoperitoneal Shunt Purposes of Shunt 603 Risks of Surgery 603 Description of Surgery 603 Surgical Management 604 Health Education 604 Complications 604 Treatment of Shunt Infections 605 147.Neuroendoscopic SurgerIndications 607 Early History 607 Rediscovery of Neuroendoscopy 608 Uses in Neuro-oncology 608 Instruments Used in Neuroendoscopy 609 Image-guided Endoscopy 610 Endoscopic Third Ventriculostomy 610 Endoscopic Applications to Neuro-oncology 611 Endoscope-assisted Microsurgery 611 Endoscopic Transsphenoidal Surgery 612 Neuroendoscopic Biopsy 612 Robot-assisted Neuroendoscopy 613 Complications of Neuroendoscopy 613 148. Microneurosurgery Pioneers in Neuroanatomy and Microneurosurgery 614 Microneurosurgical Techniques in Aneurysms 615 149. Neurosurgical Complications Factors Influencing Complications 617 Common Neurological Complications 617 Open Surgical Complications 619 Complications of Neuroendoscopy 619 Whole-brain Radiation Therapy and Stereotactic Radiosurgery Complications 619 Endovascular Complications 620 Chemotherapy Complications 620 Steroid Therapy Complications 621 150. Awake Craniotomy Description of Surgery 622 Premedication 622 Preoperative Preparation Section 17 ? Neurological Emergencies and Care 151. Neurogenic Shock Etiology 627 Pathophysiology 627 Clinical Manifestations 627 Assessment of Neurogenic Shock 628 Diagnosis and Differentiation 628 Emergency Department Care and Disposition 629 Medical Management 629 Nursing Diagnosis 629 Nursing Management 629 152. Status Epilepticus Incidence 631 Types of Status Epilepticus 631 Clinical Manifestations 631 Precipitating Factors 632 Management 633 Specific Drug Therapy 633 153. Brain Death Diagnosis 635 Guidelines for Determination 635 Pupillary Examination 636 Criteria for Brain Death 636 Assessment of Vestibulo-ocular Reflexes 636 Reflex Test 637 Apnea Test 637 Confirmatory Test for Brain Death 638 154. Neurological Intensive Care Neurological Intensive Care Unit 640 Indications of NICU Admission 640 Role of NICU in Patient Care 641 Types of Patients Treated in NICU 642 Neurocritical Care Society 645 Section 18 ? Trends in Neurology 155. Gene Therapy Gene Therapy Process 649 Types 649 Factors Influencing Gene Therapy 651 Gene Delivery Method 651 Procedure of Gene Therapy 652 Gene Therapy in Specific Neurological Disorders 652 Ethical Concern 655 156. Stem Cell Therapy Historical Development of Stem Cell Therapy 656 Accessible Sources 657 Properties of Stem Cell 657 Stem Cell-based Therapy in Neurological Diseases 658 Neurological Disorder and Stem Cell Therapy 659 Section 19 ? Therapeutic Procedure in Neuroscience 157. Cervical Traction Purposes 665 Halo Traction 665 Skeletal Tongs 665 Procedure 666 Principles of Traction 666 Nursing Application 667 158. Log-rolling Maneuver Description 668 Log-rolling Techniques 668 Bed Transfer: Logrolling 668 159. Pressure Sore Prevention and Management Pressure Sore 671 Pathology 671 High-risk Patients 671 Prevention of Pressure Sores 671 Management 672 Section 20 ? Neuropathies/Peripheral Nerve Lesions 160. Bulbar Palsy/Lower Brainstem Lesions Causes 678 Clinical Manifestations 678 Goals and Intervention 679 Pinched Nerve Syndrome 679 161. Sciatica (Sciatic Nerve Compression).......... Causes of Sciatica 680 Clinical Manifestations of Sciatica 680 Diagnostic Evaluation 680 General Principles of Treatment 681 Goal and Interventions 682 Instruction to Patient on Self-care 682 Management 683 162. Brachial Neuralgia or Neuritis Etiology 684 Pathophysiology 684 Clinical Manifestations 684xxxvi Textbook on Neurological and Neurosurgical Nursing Assessment 685 Diagnostic Evaluation 685 Goals and Intervention 685 Prognosis 686 163. Peripheral Nerve Injuries Classification 687 Erb-Duchenne Palsy 687 Klumpke’s Palsy 688 Goals and Interventions 688 Deformities 688 164. Thoracic Outlet Syndrome Etiology 690 Clinical Manifestations 691 Activities Cause Compression Syndromes 691 Assessment 691 Goals and Interventions in Thoracic Outlet Syndrome 691 165. Peripheral Neuropathy..... Epidemiology 693 Risk Factors 693 Cardinal Patterns of Neuropathy 693 Causes of Neuropathies 693 Pathological Changes 696 Clinical Manifestations 696 Types of Peripheral Neuropathy 697 Diagnostic Evaluation 698 Prevention and Screening 699 Treatment of Peripheral Neuropathies 699 Self-care Instruction to Patient 700 Alternative Medicine 700 Prognosis 701 Follow-up 701 166. Mononeuropathy Etiology 702 Management 702 Medications 702 Prevention 703 167. Mononeuritis Multiplex Clinical Manifestations 704 Management 704 Inflammatory Demyelinating Polyradiculoneuropathies 705 Nursing Care 705 168. Wilson’s Diseases Incidence 706 Etiology 706 Pathology 706 Clinical Manifestations 707 Diagnostic Evaluation Management 708 Nursing Management 709 Complications 709 Section 21 ? Neuroscience Rehabilitation 169. Introduction to Neurorehabilitation Meaning of Rehabilitation 713 Goals of Rehabilitation 713 Types of Rehabilitation 714 Approaches of Rehabilitation 714 Principles of Rehabilitation 714 Theory Application in Rehabilitation 714 Preventive Rehabilitation 715 170. Neurorehabilitation Team . Rehabilitation Team 716 Role of Physiatrist 717 Role of Rehabilitation Nurse 718 Role of Physiotherapist 718 Role of Occupational Therapist 718 Role of Clinical Psychologist 719 Role of Social and Vocational Counselors 719 Role of Orthotist 719 171. Disability Disability Process 720 Prevention of Disabilities 720 Rehabilitation for Neurological Conditions 721 Disability Due to Other Conditions 721 Activities of Daily Living Guidelines 722 Nurse’s Role in Disability Prevention 722 172. Rehabilitation of Brain Injury Traumatic Brain Injury Classification 723 Motor Disturbances 723 Sensory Disturbances 723 Rehabilitation Assessment 724 Assessment Scales 724 Rancho Los Amigos Scale 724 Other Scales 725 Management 725 Medical Treatment 725 Surgical Treatment 725 Rehabilitation: Physiotherapy and Occupational Therapy 725 Speech Therapy 727 Role of the Physiatrist 727 173. Principles of Physiotherapy Physiotherapy in Intensive Care 729 Treatment Techniques 730 Functional Rehabilitation 730xxxviii Textbook on Neurological and Neurosurgical Nursing 174. Stroke Rehabilitation Etiopathogenesis 732 Rehabilitation Assessment 732 Conscious Level Assessment 732 Higher Cortical Functions 732 Negative Prognostic Indicators 733 Complications of Stroke 733 Management 733 Positioning of Patient 735 Activities for the Recovering Arm: Occupational Therapy 735 175. Rehabilitation of Spinal Cord Injury Etiology 738 Mechanism of Injury 738 Staging 739 Syndrome Associated with Cord Injury 739 General Examination of the Patient 739 Specific Assessment 740 Psychological Evaluation 740 Nursing Assessment 740 Management of Acute SCI 740 Rehabilitation for SCI 741 Innervation of the Bladder 744 Management of Bowels 746 176. Rehabilitation for Neurodegenerative Disorders Multiple Sclerosis 748 Parkinsonism 749 Cerebellar Diseases 750 Motor Neuron Disease 751 177. Community-based Rehabilitation Goals 753 Aims of CBR Program 753 Criteria 754 Aspects 754 Members of the CBR Team 754 Role of the Rehabilitation Professional 754 Models of CBR 754 Glossary 757 Appendices 763 Index