Objective: The objective of this article is to set out consensus guidelines for the assessment an... more Objective: The objective of this article is to set out consensus guidelines for the assessment and management of “suicidal patients” in the emergency department. Conclusions: Clinicians should be respectful and reassuring. They should review old notes, conduct a full history and examination, and talk to friends, family and any practitioners already involved in the patient’s care. Management should be guided, where possible, by the patient’s preferences, not by notions of risk. Every negotiated management plan and its rationale should be carefully documented.
Objective: The objective of this article is to set out consensus guidelines for the assessment an... more Objective: The objective of this article is to set out consensus guidelines for the assessment and management of “suicidal patients” in the emergency department. Conclusions: Clinicians should be respectful and reassuring. They should review old notes, conduct a full history and examination, and talk to friends, family and any practitioners already involved in the patient’s care. Management should be guided, where possible, by the patient’s preferences, not by notions of risk. Every negotiated management plan and its rationale should be carefully documented.
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Conclusions: Clinicians should be respectful and reassuring. They should review old notes, conduct a full history and examination, and talk to friends, family and any practitioners already involved in the patient’s care. Management should be guided, where possible, by the patient’s preferences, not by notions of risk. Every negotiated management plan and its rationale should be carefully documented.
Pervasive retrograde amnesia without anterograde memory impairment has rarely been described as a consequence of
circumscribed brain damage. We report this phenomenon in a 33 yr-old, right-handed man (JG) in association with the extension
in the right thalamus of a previously small, bilateral thalamic lesion. JG presented with a dense amnesia for autobiographical
material more than a few years old, with some sparing of recent memories. Furthermore, he was completely unable to recognise
famous people or world events. Many other aspects of semantic knowledge were intact and there was no evidence of general
intellectual impairment, executive dysfunction or loss of visual imagery. Magnetic resonance imaging revealed an acute lesion in
the right thalamus and two small, symmetrical, bilateral non-acute thalamic lesions. Follow-up neuropsychological assessment
indicated a stable pattern of impaired retrograde and spared anterograde memory over 18 months and psychiatric assessments
yielded no evidence of confabulation, malingering or other symptoms to suggest psychogenic amnesia. JG’s profile indicates that
the division of declarative memory into just two categories – episodic and semantic – is inadequate. Rather, his case adds to the
growing body evidence to suggest that world knowledge pertaining to people and events is stored or accessed similarly to
autobiographical information and differently from other types of more general factual knowledge. We hypothesize that the right
mediodorsal thalamic nucleus and immediately surrounding regions comprise the central processing mechanism referred to by
McClelland (Revue Neurologique, 150 (1994) 570) and Markowitsch (Brain Research Review, 21 (1995) 117) as responsible for
inducing and co-ordinating the recall of these sorts of cortically stored memory engrams. © 2001 Elsevier Science Ltd. All rights
reserved.
Conclusions: Clinicians should be respectful and reassuring. They should review old notes, conduct a full history and examination, and talk to friends, family and any practitioners already involved in the patient’s care. Management should be guided, where possible, by the patient’s preferences, not by notions of risk. Every negotiated management plan and its rationale should be carefully documented.
Pervasive retrograde amnesia without anterograde memory impairment has rarely been described as a consequence of
circumscribed brain damage. We report this phenomenon in a 33 yr-old, right-handed man (JG) in association with the extension
in the right thalamus of a previously small, bilateral thalamic lesion. JG presented with a dense amnesia for autobiographical
material more than a few years old, with some sparing of recent memories. Furthermore, he was completely unable to recognise
famous people or world events. Many other aspects of semantic knowledge were intact and there was no evidence of general
intellectual impairment, executive dysfunction or loss of visual imagery. Magnetic resonance imaging revealed an acute lesion in
the right thalamus and two small, symmetrical, bilateral non-acute thalamic lesions. Follow-up neuropsychological assessment
indicated a stable pattern of impaired retrograde and spared anterograde memory over 18 months and psychiatric assessments
yielded no evidence of confabulation, malingering or other symptoms to suggest psychogenic amnesia. JG’s profile indicates that
the division of declarative memory into just two categories – episodic and semantic – is inadequate. Rather, his case adds to the
growing body evidence to suggest that world knowledge pertaining to people and events is stored or accessed similarly to
autobiographical information and differently from other types of more general factual knowledge. We hypothesize that the right
mediodorsal thalamic nucleus and immediately surrounding regions comprise the central processing mechanism referred to by
McClelland (Revue Neurologique, 150 (1994) 570) and Markowitsch (Brain Research Review, 21 (1995) 117) as responsible for
inducing and co-ordinating the recall of these sorts of cortically stored memory engrams. © 2001 Elsevier Science Ltd. All rights
reserved.