Acta Neurochirurgica

, Volume 34, Issue 1–4, pp 45–55 | Cite as

Assessment and prognosis of coma after head injury

  • G. Teasdale
  • B. Jennett
Assessment and Classification of Coma in Acute Stage

Summary

The Glasgow Coma Scale, based upon eye opening, verbal and motor responses has proved a practical and consistent means of monitoring the state of head injured patients. Observations made in the early stages after injury define the depth and duration of coma and, when combined with clinical features such as a patient's age and brain stem function, have been used to predict outcome. Series of cases in comparable depths of coma in Glasgow and the Netherlands showed remarkably similar outcomes at 3 months. Based upon observations made in the first 24 hours of coma after injury, data from 255 previous cases reliably predicted outcome in the majority of 92 new patients. The exceptions were patients with potential to recover who later developed complications: no patient did significantly better than predicted.

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References

  1. Bond, M. R., Outcome of severe CNS damage (Ciba Found. Symp. 34), p. 141–157. Amsterdam: Elsevier. 1975.Google Scholar
  2. Conn, H. O., Smith, H. W., Brodoff, M., Observer variation in the endoscopic diagnosis of oesophageal varices: a prospective investigation of the diagnostic validity of oesophagoscopy. New Engl. J. Med.272 (1965), 830–834.PubMedGoogle Scholar
  3. Heiskanen, O., Sipponen, P., Prognosis of severe brain injury. Acta Neurol. Scand.46 (1970), 343–348.PubMedGoogle Scholar
  4. Jennett, B., Some aspects of prognosis after severe head injury. Scand. J. Rehab. Med.4 (1972), 16–20.Google Scholar
  5. —, Bond, M. R., Assessment of outcome after severe brain damage. Lancet1 (1975,) 480–481.PubMedGoogle Scholar
  6. —, Teasdale, G., Knill-Jones, R., Predicting outcome after head injury. J. Roy. Coll. Phycns. Lond.9 (1975), 231–237.Google Scholar
  7. Knill-Jones, R., The diagnosis of jaundice by the computation of probabilities. J. Roy. Coll. Phycns. Lond.9 (1975), 205–210.Google Scholar
  8. MoCance, C., Watt, J. A., Hall, D. J., An evaluation of the reliability and validity of the plantar response in a psychogeriatric population. J. Chron. Dis.21 (1968), 369–374.Google Scholar
  9. Mitchell, D., Adams, H., Primary focal impact damage to the brainstem in blunt head injuries. Does it exist? Lancet2 (1973), 215–218.PubMedGoogle Scholar
  10. Overgaard, J., Christensen, S., Hvid-Hansen, O., Haase, J., Land, AnneMarie, Hein, O., Pedersen, K. K., Tween, W. A., Prognosis after head injury based on early clinical examination. Lancet2 (1973), 631–635.PubMedGoogle Scholar
  11. Pagni, C. A., The prognosis of head injured patients in a state of coma with decerebrated posture. J. Neuro. Sci.17 (1973), 289–305.Google Scholar
  12. Pazzaglia, P., Clinical course and prognosis of acute post-traumatic coma. J. Neurol. Neurosurg. Psychiat.38 (1975), 149–154.PubMedGoogle Scholar
  13. Plum, F., State of consciousness scoring system: Comment. J. Neurosurg.43 (1975), 251–252.PubMedGoogle Scholar
  14. —, Posner, J. B., The diagnosis of stupor and coma, 2nd Ed. Philadelphia: F. A. Davis. 1972.Google Scholar
  15. Teasdale, G. M., Acute impairment of brain function-1. Assessing “conscious level”. Nursing Times71 (1975), 914–917.PubMedGoogle Scholar
  16. —, Galbraith, S., Clarke, Kay, Acute impairment of brain function-2. Observation record chart. Nursing Times71 (1975), 972–973.PubMedGoogle Scholar
  17. —, Jennett, B., Assessment of coma and impaired consciousness: a practical scale. Lancet2 (1974), 81–84.PubMedGoogle Scholar
  18. —, Knill-Jones, R., Jennett, B., Assessing and recording conscious level. J. Neurol. Neurosurg. Psychiat.37 (1974), 1286.Google Scholar
  19. —, Smith, J., Eye movement and brainstem dysfunction after head injury. J. Neurol. Neurosurg. Psychiat.38 (1975), 822.Google Scholar
  20. Editorial. Decision in Medicine. New Engl. J. Med.293 (1975), 254–255.Google Scholar

Copyright information

© Springer-Verlag 1976

Authors and Affiliations

  • G. Teasdale
    • 1
  • B. Jennett
    • 1
  1. 1.Department of NeurosurgeryInstitute of Neurological SciencesGlasgowScotland

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