Saturday, August 3 (2019); Neurology and Neurosurgery
This is where the money is, as far as the ICU cranial nerve examination is concerned. Unfortunately, this important topic has only come up once in the last 15 years - Question 5 from the first paper of 2007 asked about pupil reactivity and diameter in the context of coma.The eyes, the poets say, are the windows to the soul. To the unpoetic intensivist, they are more like keyholes into the dressing room of the upper brainstem, and barometers of intracranial pressure. Rather than escaping into comforting familiarity of well-known examination medicine textbooks, I will instead refer to a more ancient and venerable "Clinical Methods: The History, Physical, and Laboratory Examinations (3rd edition)" - specifically Chapter 58, by Rober H Spector. Unlike the crisp and clean interior of Talley and O'Connor, this hoary incunabula is overgrown with trailing fronds of references, featuring obscure and apocryphal authors, and discussing rare and extinct physical findings.