Prognosis in Patients With Severe Head Injury
Data been collected prospectively on patients with severe head injury—studied in collaboration between Glasgow, Rotterdam, Groningen, and Los Angeles1. This data bank allows detailed analysis of the relationship between early features in the head-injured patient at various stages in the first week after injury, and ultimate outcome. All patients were in coma for at least six hours after injury, although in a third of cases this developed only after a period of relative lucidity. Coma was defined as “no eye-opening, no uttering of words, no obedience to commands”, no matter how strong a stimulation was applied. This definition is comparable to that suggested by the Coma Committee of the WFNS—a state of “unrousable unresponsiveness”2. Severity in the early stages after injury has been assessed by clinical criteria: responsiveness on the Glasgow Coma Scale, abnormal motor patterns, pupillary responses, eye movements, and autonomic responses.
KeywordsGlasgow Coma Scale Data Bank Severe Head Injury Pupillary Response Intracranial Haematoma
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