Cognitive behavioural therapy, which includes exposure and cognitive restructuring, was found to be effective in preventing PTSD in patients diagnosed with acute stress disorder with clinically significant results at six-month follow-up appointments. A combination of relaxation, cognitive restructuring, imaginal exposure, and in-vivo exposure was superior to supportive counselling. Mindfulness-based stress reduction programmes also appear to be effective for stress management.The pharmacological approach has made some progress in lessening the effects of ASD. To relax patients and allow for better sleep, Prazosin can be given to patients, which regulates their sympathetic response. Hydrocortisone has shown some success as an early preventative measure following a traumatic event, typically in the treatment of PTSD.In a wilderness context where counselling, psychotherapy, and cognitive behavioural therapy is unlikely to be available, the treatment for acute stress reaction is very similar to the treatment of cardiogenic shock, vascular shock, and hypovolemic shock; that is, allowing the patient to lie down, providing reassurance, and removing the stimulus that prompted the reaction. In traditional shock cases, this generally means relieving injury pain or stopping blood loss. In an acute stress reaction, this may mean pulling a rescuer away from the emergency to calm down or blocking the sight of an injured friend from a patient. History
The term "acute stress disorder" was first used to describe the symptoms of soldiers during World War I and II, and it was therefore also termed "combat stress reaction" (CSR). Approximately 20% of U.S. troops displayed symptoms of CSR during WWII.
Jugular foramen syndrome, or Vernets syndrome, is characterized by paresis of the glossopharyngeal, vagal, and accessory (with or without the hypoglossal) nerves. Symptoms
Symptoms of this syndrome are consequences of this paresis. As such, an affected patient may show:
dysphonia/hoarseness
soft palate dropping
deviation of the uvula towards the normal side
dysphagia
loss of sensory function from the posterior 1/3 of the tongue (CN IX)
decrease in the parotid gland secretion (CN IX)
loss of gag reflex
sternocleidomastoid and trapezius muscles paresis (CN XI)

Causes
Glomus tumors (most frequently)
Meningiomas
Schwannomas (Acoustic neuroma)
Metastatic tumors located at the cerebellopontine angle
Trauma
Fracture of occipital bone
Infections
Cholesteatoma (very rare)
Obstruction of the jugular foramen due to bone diseases
Nasopharyngeal carcinoma spreading into the parapharyngeal space involving the ninth, tenth, and eleventh cranial nerves

Diagnosis
Gadolinium enhanced mri for vestibular schwannoma
mri and biopsy for nasopharyngeal carcinoma
based on nerve palsies
NCCT for occipital bone fracture


== References ==