Advertisement

Coma

  • Marialuisa Bozza-Marrubini

Abstract

Coma, the ‘deep sleep’ of ancient Greeks, is currently defined in neurology as ‘unarousable unresponsiveness’ [120]. Other definitions are all centered on the abolition of consciousness and on defects in the arousal mechanisms (Table 42.1). In the care of critically ill patients the term ‘coma’ is commonly used in the broader sense of a disturbance in consciousness, with all its physiopathological consequences. “Impaired or decreased consciousness reflects severe brain dysfunction, and coma means brain failure [our italics], just as uremia means renal failure” [120].

Keywords

Severe Head Injury Persistent Vegetative State Severe Brain Injury Brain Failure Traumatic Coma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Anderson DC, Cranford RE (1979) Corticosteroids in ischaemic stroke. Stroke 10:68–71 736 Care of the Critically Ill PatientGoogle Scholar
  2. 2.
    Bareggi SR, Porta M, Selenati A, Assael BM, Calderini G, Collice M, Rossanda M, Morselli PL (1975) Homovanillic acid and 5-hydroxyindole-acetic acid in the CSF of patients after a severe head injury. Eur Neurol 13: 528–544PubMedCrossRefGoogle Scholar
  3. 3.
    Barge M, Ohanessian J, Baum L, Benabid AL, Chirossel JP (1977) Valeur diagnostique et prognostique des réflexes du tronc cérébral dans les comas post-traumatiques graves. Neurochirurgie 23: 227–238PubMedGoogle Scholar
  4. 4.
    Barge M, Ohanessian J, Garrel S, Benabid AL, Chirossel JP (1978) Le stade mésodiencéphalique des traumatismes craniens graves. Neurochirurgie 24: 33–36PubMedGoogle Scholar
  5. 5.
    Bates D, Caronna TJ, Cartlidge NEF, Knill-Jones MB, Levy DE, Shaw MB, Plum F (1977) A prospective study of non-traumatic coma: methods and results in 310 patients. Ann Neurol 2: 211–220PubMedCrossRefGoogle Scholar
  6. 6.
    Becker DP, Miller JD, Ward JD, Greenberg RP, Young HF, Sakalas R (1977) The outcome of severe brain injury. J Neurosurg 47: 491–502PubMedCrossRefGoogle Scholar
  7. 7.
    Bell JA, Hodgson JHF (1974) Coma after cardiac arrest. Brain 97: 361–372PubMedCrossRefGoogle Scholar
  8. 8.
    Bergamasco B, Bergamini L, Doriguzzi T, Fabiani D (1968a) EEG sleep patterns as a prognostic criterion in post-traumatic coma. Electroencephalogr Clin Neurophysiol 24: 374–377PubMedCrossRefGoogle Scholar
  9. 9.
    Bergamasco B, Bergamini L, Doriguzzi T (1968) Clinical value of the sleep electroencephalographic patterns in post-traumatic coma. Acta Neurol Scand 44: 495–511 (1968b)Google Scholar
  10. 10.
    Berntman L, Dahlgren N, Siesjö BK (1979a) Cerebral blood flow and oxygen consumption in the rat brain during extreme hypercarbia. Anesthesiology 50: 299305Google Scholar
  11. 11.
    Berntman L, Carlsson C, Siesjö BK (1979b) Cerebral oxygen consumption and blood flow in hypoxia: Influence of sympathoadrenal activation. Stroke 10: 2025Google Scholar
  12. 12.
    Bidabe-Renou AM, Constant P, Caille JM, Vernet J (1978) Vasoréactivité des infarctus cérébraux aux barbituriques et autres anesthésiques intraveineux. Ann Anesthesiol Fr 19: 821–826PubMedGoogle Scholar
  13. 13.
    Binnie CD, Prior PF, Lloyd DSL, Scott DF, Margerison JH (1970) Electroencephalographic prediction of fatal anoxic brain damage after resuscitation from cardiac arrest. Br Med J iv: 265–268Google Scholar
  14. 14.
    Bleyaert AL, Nemoto EM, Safar P, Stezoski SW, Mick-ell JJ, Moossy J, Rao Gll(1978a) Tiopental amelioration of brain damage after global ischaemia in monkeys. Anesthesiology 49: 390–398Google Scholar
  15. 15.
    Bleyaert AL, Safar P, Stezoski SW, Nemoto EM, Moossy J (1978b) Amelioration of postischaemic brain damage in the monkey by immobilization and controlled ventilation. Crit Care Med 6: 112–113CrossRefGoogle Scholar
  16. 16.
    Bond MR (1975) Assessment of the psychosocial outcome after severe head injury. In: Outcome of severe CNS damage. Ciba Foundation Symp 34, Elsevier Excerpta Medica, Amsterdam, pp 141–155Google Scholar
  17. 17.
    Bouzarth WF (1968) Neurosurgical watch sheet for craniocerebral trauma. J Trauma 8: 29–31PubMedCrossRefGoogle Scholar
  18. 18.
    Bozza-Marrubini M (1961) Rianimazione. I. Alterazioni del sensorio. In: Bozza-Marrubini M, RossandaGoogle Scholar
  19. M, et al (eds) Anestesia e rianimazione nella chirurgia e nella traumatologia del sistema nervoso centrale. Minerva Anestesiol 27:365–430.Google Scholar
  20. 19.
    Bozza-Marrubini M (1964) Resuscitation treatment of the different degrees of unconsciousness. Acta Neurochir (Wien) 12: 352–365CrossRefGoogle Scholar
  21. 20.
    Bozza-Marrubini M, Boselli L, Ghezzi R, Iato E, Selenati A (1979) Physostigmine salicilate as an antidote in poisoning by drugs with central anticholinergic activity. Experience in 52 cases. In: Okonek S, Fülgraff G, Frey R (eds) Humantoxicologie. Fischer, Stuttgart New York, p 85–94 20a. Bozza-Marrubini M, Ghezzi R, Iato E, Scaiola A, Selenati A, Toso A (1981) Methodology of coma classification. Crit Care Med 9: 151Google Scholar
  22. 21.
    Branston NM, Hope DT, Symon L (1979) Barbiturates in focal ischemia of primate cortex: Effects on blood flow distribution, evoked potential and extracellular potassium. Stroke 10: 647–53Google Scholar
  23. 22.
    Breivik H, Safar P, Sands P, Fabritius R, Lind B, Lust P, Mullie A, Orr M, Renck H, Snyder JV (1978) Clinical feasibility trials of barbiturate therapy after cardiac arrest. Crit Care Med 6: 228–44PubMedCrossRefGoogle Scholar
  24. 23.
    Brendler SJ, Selverstone B (1970) Recovery from de-cerebration. Brain 93: 381–392PubMedCrossRefGoogle Scholar
  25. 24.
    Brennan RW (1978) Resuscitation from metabolic coma and encephalitis. Crit Care Med 6: 277–283PubMedCrossRefGoogle Scholar
  26. 25.
    Bricolo A, Turella G (1973) Electroencephalographic patterns of acute traumatic coma: diagnostic and prognostic value. J Neurol Sci 17: 278–285Google Scholar
  27. 26.
    Bricolo A, Gentilomo A, Rosadini G, Rossi GF (1968) Long-lasting post-traumatic unconsciousness. A study based on nocturnal EEG and polygraphic recording. Acta Neurol Scand 44: 512–532Google Scholar
  28. 27.
    Bricolo A, Battistini N, Bergamini L, Columella F, Loeb C, Mingrino S, Rossi GF, Terzian H (1975) A proposal for the clinical classification of acute coma due to organic cerebral lesions. J Neurosurg Sci 19: 113–119PubMedGoogle Scholar
  29. 28.
    Bricolo A, Turazzi S, Alexandre A, Rizzuto N (1977) Decerebrate rigidity in acute head injury. J Neurosurg 47: 680–98PubMedCrossRefGoogle Scholar
  30. 29.
    Bricolo A, Turazzi S, Faccioli F, Odorizzi F, Sciaretta G, Erculian P (1978) Clinical application of compressed spectral array in long-term EEG monitoring of comatose patients. Electroencephalogr Clin Neurophysiol 45: 211PubMedCrossRefGoogle Scholar
  31. 30.
    Brinkmann R, Von Cramon D, Schulz H (1976) The Munich Coma Scale ( MCS ). J Neurol Neurosurg Psychiatry 39: 788–793Google Scholar
  32. 31.
    Bruce DA, Gennarelli TA, Langfitt TW (1978) Resuscitation from coma due to brain injury. Crit Care Med 6: 254–269PubMedCrossRefGoogle Scholar
  33. 32.
    Bruce DA, Raphaely RA, Swedlow D, Schut L (1980) The effectiveness of iatrogenic barbiturate coma in controlling increased ICP in 61 children. In: Shulman K, Marmarou A, Miller JD, et al (eds) Intracranial Pressure, vol iv. Springer, Berlin Heidelberg New York, pp 630–632Google Scholar
  34. 33.
    Calderini C, Carlsson A, Nordström CH (1978) Influence of transient ischemia on monoamine metabolism in the rat brain during nitrous oxide and phenobarbitone anaesthesia. Brain Res 157: 303–310PubMedCrossRefGoogle Scholar
  35. 34.
    Carlsson CA, Von Essen C, Lofgren J (1968) Factors affecting the clinical course of patients with severe head injuries. 1. Influence of biological factors. 2. Significance of posttraumatic coma. J Neurosurg 29: 242–251Google Scholar
  36. 35.
    Castellano F, Perna E, Liguori R, Petrone G (1973) Contributo al trattamento del coma cerebrale traumatico con la citidin-difosfocolina ( CDP-colina ). Rass Internaz Clin Terap 53: 63–88Google Scholar
  37. 36.
    Chatrian GE, White LE, Daly D (1963) Electroencephalographic patterns resembling those of sleep in certain comatose states after injuries of the head. EEG Clin Neurophysiol 15: 272–280CrossRefGoogle Scholar
  38. 37.
    Chiappa KH, Burke SR, Young RT (1979) Results of electroencephalographic monitoring during 367 carotid endarterectomies. Use of a dedicated minicomputer. Stroke 10: 381–388Google Scholar
  39. 38.
    Christensen MS (1976) Prolonged artificial hyperventilation in cerebral apoplexy. Acta Anaesthesiol Scand [Suppl] 62: 1–24CrossRefGoogle Scholar
  40. 39.
    Christensen MS, Boderson P, Oleson J (1973) Cerebral apoplexy (stroke) treated with or without prolonged artificial hyperventilation: 2 CSF acid base balance and intracranial pressure. Stroke 4: 620–31PubMedCrossRefGoogle Scholar
  41. 40.
    Ciba Foundation (1975) Outcome of severe damage to the central nervous system. Elsevier Excerpta Medica, North Holland (Symposium no. 34 )Google Scholar
  42. 41.
    Cold GE, Jensen FT, Malmros R (1977a) The cerebro-vascular CO2 reactivity during the acute phase of brain injury. Acta Anaesthesiol Scand 21: 222–31PubMedCrossRefGoogle Scholar
  43. 42.
    Cold GE, Jensen FT, Malmros R (1977b) The effects of PaCO2 reduction on regional cerebral blood flow in the acute phase of brain injury. Acta Anaesthesiol Scand 21: 359–67PubMedCrossRefGoogle Scholar
  44. 43.
    Collice M, Versari P, Vecchi G, Scornajenghi A, D’Angelo V (1980) Role of ICP monitoring in patients suffering from severe brain injuries. In: Shulman K, Marmarou A, Miller JD (eds) Intracranial pressure, vol IV. Springer, Berlin Heidelberg New York, pp 17–19Google Scholar
  45. 44.
    Cooper PR, Moody S, Clark K, Kirkpatrick J, Maravilla K, Gould AL, Drane W (1979) Dexamethasone and severe head injury. A prospective double-blind study. J Neurosurg 51: 307–316Google Scholar
  46. 45.
    Corrodi H, Fuxe K, Lidbrink P, Olsson L (1971) Minor tranquilizers, stress and central catecholamine neurons. Brain Res 29: 1–16PubMedCrossRefGoogle Scholar
  47. 46.
    De Jong R (1979) The neurologic examination, 4th edn. Harper & Row, HagerstonGoogle Scholar
  48. 47.
    Demopoulos HB, Milvy P, Kakari S, Ransohoff J (1972) Molecular aspects of membrane structures in cerebral edema. In: Reulen HJ, Schürmann K (eds) Steroids and brain edema. Springer, Berlin Heidelberg New York, p 29: 39Google Scholar
  49. 48.
    Demopoulos HB, Flamm ES, Seligman ML, Power R, Pietronigro D, Ransohoff J (1977a) Molecular pathology of lipids in CNS membranes. In: Jöbsis FF (ed) Oxygen and physiological function. Professional Information Library, Dallas Texas, pp 491–508Google Scholar
  50. 49.
    Demopoulos HB, Flamm ES, Seligman ML, Jorgensen E, Ransohoff J (1977b) Antioxidant effects of barbiturates in model membranes undergoing free radical damage. Acta Neurol Scand 56 [Suppl] 64: 152–153Google Scholar
  51. 50.
    Espagno J, Trémoulet M, Gigaud M, Espagno CH (1979) Etude de l’action de la CDP-choline dans les troubles de la vigilance post-traumatique. La Vie Médicale 3: 195–196Google Scholar
  52. 51.
    Faupel G, Reulen HJ, Muller D (1977) Double-blind study on the effects of dexamethasone on severe closed head injury. In: Pappius H, Reulen H (eds) Second International Workshop on cerebral edema, Montreal, 1976. Springer, BerlinGoogle Scholar
  53. 52.
    Fazekas JF, Alman RW (1962) Coma. Biochemistry, physiology and therapeutic principles. Thomas, Springfield, p 3Google Scholar
  54. 53.
    Fischgold H, Mathis P (1959) Obnubilations, comas et stupeurs. Masson, ParisGoogle Scholar
  55. 54.
    Flamm ES, Demopoulos HB, Seligman ML, Ransohoff J (1977) Possible molecular mechanisms of barbiturate-mediated protection in regional cerebral ischemia. Acta Neurol Scand 56 [Suppl 641 150–151Google Scholar
  56. 55.
    Fleischer AS, Payne NS, Tindall GT (1976) Continuous monitoring of intracranial pressure in severe closed head injury without mass lesions. Surg Neurol 6: 31–4PubMedGoogle Scholar
  57. 56.
    Frowein RA (1976) Classification of coma. Acta Neurochir (Wien) 34: 5–10CrossRefGoogle Scholar
  58. 57.
    Gobiet W, Bock WJ, Liesegang J, Grote W (1976) Treatment of acute cerebral edema with high dose dexamethasone. In: Beks JWF, Bosch DA, Brock M (eds) Intracranial pressure, vol III. Springer, Berlin Heidelberg New York, pp 231–235CrossRefGoogle Scholar
  59. 58.
    Gordon E (1971a) Controlled respiration in the management of patients with traumatic brain injuries. Acta Anaesthesiol Scand 15: 193–208PubMedCrossRefGoogle Scholar
  60. 59.
    Gordon E (1971b) The acid-base balance and oxygen tension of the cerebrospinal fluid, and their implications for the treatment of patients with brain lesions. Acta Anaesthesiol Scand [Suppl] 34: 1–36CrossRefGoogle Scholar
  61. 60.
    Goulon M, Gajdos P, Margent P, Raphael JC, Barois A, Combes A, Grosbuis S, Levy-Alcover M, Gastinne H (1977) Neurological problems in intensive care. In: Neurology. Proc 11th World Congress of Neurology, Amsterdam, 1977. Excerpta Medica, Amsterdam Oxford, pp 283–298 (International Congress series no. 434)Google Scholar
  62. 61.
    Gudeman SK, Miller JD, Becker DP (1979) Failure of high-dose steroid therapy to influence intracranial pressure in patients with severe head injury. J Neurosurg 51: 301–306PubMedCrossRefGoogle Scholar
  63. 62.
    Hägerdal M, Welsh FA, Keykhah MM, Perez E, Harp JR (1978) Protective effects of combinations of hypothermia and barbiturates in cerebral hypoxia in the rat. Anesthesiology 49: 165–169PubMedCrossRefGoogle Scholar
  64. 63.
    Hägerdal M, Keykhah M, Perez E, Harp JR (1979) Additive affects of hypothermia and phenobarbital upon cerebral oxygen consumption in the rat. Acta Anaesthesiol Scand 23: 89–92PubMedCrossRefGoogle Scholar
  65. 64.
    Hakim AM, Moss G (1976) Cerebral effects of barbiturate-shift from energy to synthesis metabolism for cellular viability. Surg Forum 27: 497–499PubMedGoogle Scholar
  66. 65.
    Hoff JT (1978) Resuscitation in focal brain ischemia. Crit Care Med 6: 245–253PubMedCrossRefGoogle Scholar
  67. 66.
    Horton JM (1976) The anaesthetist’s contribution to the care of head injuries. Br J Anaesth 48: 767–771PubMedCrossRefGoogle Scholar
  68. 67.
    Huger F, Patrick G (1979) Effect of concussive head injury on central catecholamine levels and synthesis rates in rat brain regions. J Neurochem 33: 89–95PubMedCrossRefGoogle Scholar
  69. 68.
    Ito U, Ohno K, Suganuma Y, Suzuki K, Inaba Y (1980) Effect of steroid in ischemic brain edema. Analysis of cytotoxic and vasogenic edema occurring during ischemia and after restoration of blood flow. Stroke 11: 166172Google Scholar
  70. 69.
    Jackson DL, Dole WP (1979) Total cerebral ischemia: A new model system for the study of post cardiac arrest brain damage. Stroke 10: 38–42Google Scholar
  71. 70.
    Jennett B (1979) Severe head injury: Prediction of outcome as a basis for management decisions. In: Trubuhovic RV (ed) Management of acute intracranial disasters. Little Brown, Boston, p 133–152Google Scholar
  72. 71.
    Jennett B, Bond M (1975) Assessment of outcome after severe brain damage. A practical scale. Lancet 1: 480484Google Scholar
  73. 72.
    Jennett B, Plum F (1972) The persistent vegetative state after brain damage: A syndrome in search of a name. Lancet I: 734–737Google Scholar
  74. 73.
    Jennett B, Teasdale G (1977) Aspects of coma after severe head injury. Lancet I: 878–81Google Scholar
  75. 74.
    Jennett B, Teasdale G, Braakman R, Minderhoud J, Knill-Jones R (1976) Predicting outcome in individual patients after severe head injury. Lancet I: 1031–4Google Scholar
  76. 75.
    Jouvet M (1961) Essai de classification des troubles chroniques de la conscience post-traumatiques. In: Wertheimer P, Descotes J (eds) Traumatologie cranienne. Masson, Paris, p 75–83Google Scholar
  77. 76.
    Jouvet M (1969) Coma and other disorders of consciousness In: Vinken PJ, Bruyn GW (eds) Handbook of clinical neurology, vol 3. North Holland, Amsterdam, pp 62–79Google Scholar
  78. 77.
    Kofke WA, Nemoto EM, Hossmann KA, Taylor F, Kessler PD, Stezoski SW (1979) Brain blood flow and metabolism after global ischemia and post-insult thiopental therapy in monkeys. Stroke 10: 554–60PubMedCrossRefGoogle Scholar
  79. 78.
    Korf J, Aghajanian GK, Roth RH (1973) Increased turnover of norepinephrine in the rat cerebral cortex during stress. Role of the locus coeruleus. Neuro-pharmacology 12: 933–8Google Scholar
  80. 79.
    Kugelmass IN (1962) Foreword. In: Fazekas JF, Alman RW (eds) Coma, biochemistry physiology and therapeutic principles. Thomas, Springfield, p V IGoogle Scholar
  81. 80.
    Lafferty JJ, Keykhah MM, Shapiro HM, Van Horn K, Behaz MG (1978) Cerebral hypometabolism obtained with deep pentobarbital anesthesia and hypothermia (30° C). Anesthesiology 49:159–164 80a. Lancet (1963) Coma with injury to chest. (Editorial) Lancet I:1151 80b. Lancet (1973) Predicting utcome after severe brain damage. (Editorial) Lancet L•523–524Google Scholar
  82. 81.
    Langfitt TW (1976) The incidence and importance of intracranial hypertension in head injured patients. In: Beks JWF, Bosch DA, Brock M (eds) Intracranial pressure, vol III. Springer, Berlin, pp 67–72CrossRefGoogle Scholar
  83. 82.
    Langfitt TW (1978) Measuring the outcome from head injuries. J Neurosurg 48: 673–8PubMedCrossRefGoogle Scholar
  84. 83.
    Lassen NA, Palvalgyi R (1968) Cerebral steal during hypercapnia and the inverse reaction during hypocapnia observed by the 133 xenon technique in man. Scand J Clin Lab Invest [Suppl] 102: XIII DGoogle Scholar
  85. 84.
    Lawner P, Laurent J, Simeone F, Fink E, Rubin E (1979) Attenuation of ischemic brain edema by pentobarbital after carotid ligation in the gerbil. Stroke 10: 644–47PubMedCrossRefGoogle Scholar
  86. 85.
    Levati A (1977) Possibilità di prognosi precoce nel traumatizzato cranicoencefalico. Importanza del livello di coma e dell’età. Thesis, University of MilanGoogle Scholar
  87. 86.
    Levin HS, Grossmann RG, Rose JE, Teasdale G (1979) Long-term neuropsychological outcome of closed head injury. J Neurosurg 50: 412PubMedCrossRefGoogle Scholar
  88. 87.
    Levy D, Bates D, Caronna J, Cartlidge N, Knill-Jones R, Shaw D, Plum F (1978) Recovery from nontraumatic coma. Ann Neurol 4: 169–170Google Scholar
  89. 88.
    Loeb C, Rosadini G, Poggio GF (1959) Electroencephalograms during coma. Neurology 9: 610–9PubMedCrossRefGoogle Scholar
  90. 89.
    Maclver IN, Frew IJC, Matheson JG (1958) The role of respiratory insufficiency in the mortality of severe brain injuries. Lancet I: 390–3Google Scholar
  91. 90.
    Majewska MD,. Stroznajder J, Lazarewicz J (1978) Effect of ischemic anoxia and barbiturate anesthesia on free radical oxidation of mitochondrial phospholipids. Brain Res 158: 423–34CrossRefGoogle Scholar
  92. 91.
    Mannelli A, Silvestri A, Conti-Bizzarro C, Bonagura A (1973) Trattamento di alcuni casi di coma di origine traumatica con la CDP colina. Incontri Anest Rianim e Scienze affini 8: 209–232Google Scholar
  93. 92.
    Marrubini G (1966) Anatomia patologica nel traumatizzato cranio-encefalico, In: Panel sulla rianimazione in neurologia e neurochirurgia. Minerva Anestesiol 32: 449–477Google Scholar
  94. 93.
    Marsh ML, Marshall LF, Shapiro HM (1977) Neurosurgical intensive care. Anesthesiology 47: 149–163PubMedCrossRefGoogle Scholar
  95. 94.
    Marshall M (1979) Neuro-anaesthesia. Edward Arnold, p 35Google Scholar
  96. 95.
    Marshall LF, Shapiro HM (1977) Barbiturate control of intracranial hypertension in head injury and other conditions: latrogenic coma. Acta Neurol Scand [Suppl] 56 /64: 156–7Google Scholar
  97. 96.
    Marshall LF, Shapiro HM (1980) Barbiturates for intracranial hypertension: A ten year perspective. In: Shulman K, Marmarou A, Miller JD et al. (eds) Intracranial Pressure, vol IV. Springer, Berlin Heidelberg New York, pp 627–629Google Scholar
  98. 97.
    Marshall LF, Shapiro HM, Rauscher A, Kaufman NM (1978) Pentobarbital therapy for intracranial hypertension in metabolic coma. Reyé s syndrome. Crit Care Med 6: 1–5Google Scholar
  99. 98.
    Masson M, Henin D (1979) Les comas. Encycl Méd Chir, Paris. Neurologie 17023 A-1012Google Scholar
  100. 99.
    Matthew H, Lawson AAH (1975) Treatment of common acute poisonings. Churchill Livingstone, Edinburgh London New York, pp 18–19Google Scholar
  101. 100.
    McGraw CP, Howard G (1980) Effects of barbiturates on intracranial pressure and the amount of mannitol required to control the intracranial pressure. In: Shulman K, Marmarou A, Miller JD, et al (eds) Intracranial pressure, vol IV. Springer, Berlin Heidelberg New York, pp 633–635Google Scholar
  102. 101.
    Michenfelder JD (1974) The interdependency of cerebral functional and metabolic effects following massive doses of thiopental in the dog. Anesthesiology 41: 231–6PubMedCrossRefGoogle Scholar
  103. 102.
    Michenfelder JD (1978) Hypothermia plus barbiturates. Apples plus oranges? Anesthesiology 49: 157–158PubMedCrossRefGoogle Scholar
  104. 103.
    Michenfelder JD, Milde JH (1977) Failure of prolonged hypocapnia, hypothermia, or hypertension to favorably alter acute stroke in primates. Stroke 8: 87–91PubMedCrossRefGoogle Scholar
  105. 104.
    Michon P, Larcan A (1961) Agression et réanimation en médecine interne. Masson, Paris, 397Google Scholar
  106. 105.
    Mollaret P, Goulon M (1959) Le coma dépassé. Rev Neurol (Paris) 101: 3Google Scholar
  107. 106.
    Mombelli F, Sargenti L, Levati A, Livini M, Stern M, Bozza-Marrubini M, Iato E (1979) II CFM ( Cerebral Function Monitor) un nuovo strumento per la valutazione dell’attività funzionale cerebrale in anestesia e rianimazione. Anestesia e Rianimazione 20: 241–60Google Scholar
  108. 107.
    Mullie’ A, Lust P, Penninckx J, Vanhove L, Miranda R, Hainaux M, Spincemaille J (1978) Utilization clinique du thiopental dans l’encephalopathie postischemique. Rapport preliminaire. Ann Anesthesiol Fr 19: 833–41Google Scholar
  109. 108.
    Nemoto EM (1978) Pathogenesis of cerebral ischemia-anoxia. Crit Care Med 6: 203–214PubMedCrossRefGoogle Scholar
  110. 109.
    Nemoto EM, Bleyaert AL, Stezoski SW, Moossy J, Gutti RR, Safar P (1977) Global brain ischemia: A reproducible monkey model. Stroke 8: 558–564Google Scholar
  111. 110.
    Nemoto EM, Shiu GK, Gilbertson JR, Alexander H (1980) Brain free fatty acids after transient global brain ischemia with postinsult thiopental therapy. In: Shulman K, Marmarou A, Miller JD (eds) Intracranial Pressure vol IV. Springer, Berlin Heidelberg New York, p 307–311Google Scholar
  112. 111.
    Nilsson L, Siesjö BK (1975) The effect of phenobarbitone anaesthesia on blood flow and oxygen consumption in the rat brain. Acta Anaesthesiol Scand [Suppl] 57: 18–24CrossRefGoogle Scholar
  113. 112.
    Obrist WD, Gennarelli TA, Segawa H, Dolinskas CA, Langfitt TW (1979) Relation of cerebral blood flow to neurological status and outcome-in head injured patients. J Neurosurg 51: 292–300PubMedCrossRefGoogle Scholar
  114. 113.
    Ommaya AK, Sadowsky D (1966) A system of coding medical data for punched-card machine retrieval. J Trauma 6: 605–617PubMedCrossRefGoogle Scholar
  115. 114.
    Ottonello GA, Primavera A (1979) Gastrointestinal complication of high-dose corticosteroid therapy in acute cerebrovascular patients. Stroke 10: 208–10PubMedCrossRefGoogle Scholar
  116. 115.
    Overgaard J, Christensen S, Hvid-Hansen O, Haase J, Land A, Hein O, Pedersen KK, Tweed WA (1973) Prognosis after head injury based on early clinical examination. Lancet II: 631–635Google Scholar
  117. 116.
    Pampiglione G, Harden A (1968) Resuscitation after cardiocirculatory arrest. Prognostic evaluation of early electroencephalographic findings. Lancet I: 1261–1267Google Scholar
  118. 117.
    Pitts LH, Kaktis JV (1980) Effect of megadose steroids on ICP in traumatic coma. In: Shulman K, Marmarou A, Miller JD, et al (eds) Intracranial pressure vol IV. Springer, Berlin Heidelberg New York, pp. 638–642Google Scholar
  119. 118.
    Pitts LH, Kaktis JV, luster R, Heilbron D (1980) ICP and outcome in patients with severe brain injury. In: Shulman K, Marmarou A, Miller JF, et al. (eds) Intracranial pressure vol IV. Springer Verlag, Berlin Heidelberg New York, p 5–9Google Scholar
  120. 119.
    Plum F (1972) Organic disturbances of consciousness In: Critchley M, O’Leary J, Jennett BW (eds) Scientific foundations of neurology. Heinemann Med Books, London, p 193–201Google Scholar
  121. 120.
    Plum F, Posner JB (1966) The diagnosis of stupor and coma. Blackwell Scientific Publications, OxfordGoogle Scholar
  122. 121.
    Plum F, Caronna JJ (1975) Can one predict outcome of medical coma? In: Outcome of severe damage to the central nervous sytem. Elsevier/Excerpta Medica, North Holland, 121–136 (Ciba Foundation Symposium no. 34)Google Scholar
  123. 122.
    Porta M, Bareggi SR, Selenati A, Assael BM, Beduschi A, Morselli PL (1973) Acid monoamines metabolites in ventricular and lumbar cerebrospinal fluids of patients in post-traumatic coma. J Neurosurg Sci 17: 230–237Google Scholar
  124. 123.
    Poulsen J, Zilstorff K (1972) Prognostic value of the caloric-vestibular test in the unconscious patient with cranial trauma. Acta Neurol Scand 48: 282–292PubMedCrossRefGoogle Scholar
  125. 124.
    Price DJ, Knill Jones R (1977) Prognosis of severe head injury in 150 patients with coma and bilateral fixed pupils. Intensive Care Med 3: 167Google Scholar
  126. 125.
    Prior PF (1973) The EEG in acute cerebral anoxia. Excerpta Medica, Amsterdam 125a. Prior PF ( 1979 ) Monitoring cerebral function. North Holland, ElsevierGoogle Scholar
  127. 126.
    Reed CE, Driggs MF, Foote CC (1952) Acute barbiturate intoxication: A study of 300 cases based on a physiologic system of classification of the severity of the intoxication. Ann Intern Med 37: 290–303PubMedGoogle Scholar
  128. 127.
    Rockoff MA, Marshall LF, Shapiro HM (1979) High-dose barbiturate therapy in humans: A clinical review of 60 patients. Ann Neurol 6: 194–199PubMedCrossRefGoogle Scholar
  129. 128.
    Rossanda M (to be published) Basi fisiopatologiche e problemi clinici della rianimazione in neurochirurgia. In: Damia G et al (eds) Trattato enciclopedico italiano di anestesia, rianimazione, terapia intensiva, tossicologia d’urgenza e terapia del dolore. Piccin, PadovaGoogle Scholar
  130. 129.
    Rossanda M (1968) Prolonged hyperventilation in treatment of unconscious patients with brain injury. Scand J Clin Lab Invest [Suppl] 102: XIII EGoogle Scholar
  131. 130.
    Rossanda M, Di Giugno G, Corona S, Bettinazzi N, Mangione G (1966) Oxygen supply to the brain and respirator treatment in severe comatose states. Acta Anaesthesiol Scand 3 [Suppl XXIII]: 766–74CrossRefGoogle Scholar
  132. 131.
    Rossanda M, Boselli L, Castelli A, Corona C, Erminio F, Nardini M, Porta M, Villa C (1972) Effects of changes in PaCO2 on rCBF, cerebral oxygenation and EEG in severe brain injuries. Eur Neurol 8: 169–173PubMedCrossRefGoogle Scholar
  133. 132.
    Rossanda M, Selenati A, Villa C, Beduschi A (1973) Role of automatic ventilation in treatment of severe head injuries. J Neurosurg Sci 17: 265–70Google Scholar
  134. 133.
    Rowbotham GF (1949) Acute injuries of the head. Livingstone, Edinburgh, pp 123–125Google Scholar
  135. 134.
    Rutherford WH (1977) Diagnosis of alcohol ingestion in mild head injuries. Lancet 1: 1021–1023PubMedCrossRefGoogle Scholar
  136. 135.
    Safar P, Nemoto E (1978) Brain resuscitation. Acta Anaesthesiol Scand [Suppl] 70: 60–74Google Scholar
  137. 136.
    Safar P, Bleyaert A, Nemoto EM, Moossy J, Snyder JV (1978) Resuscitation after global brain ischemia anoxia. Crit Care Med 6: 215–227PubMedCrossRefGoogle Scholar
  138. 137.
    Sawada Y, Takahashi M, Ohashi N, Fusamoto H, Maemura K, Kobayashi H, Yoshioka T, Sugimoto T (1980) Computerised tomography as an indication of long-term outcome after acute carbon monoxide poisoning. Lancet I: 783–784Google Scholar
  139. 138.
    Severinghaus JW (1965) Role of cerebrospinal fluid pH in normalization of cerebral blood flow in chronic hypocapnia. Acta Neurol Scand [Suppl] 14: 116–120Google Scholar
  140. 139.
    Severinghaus JW, Lassen N (1967) Step hypocapnia to separate arterial from tissue PCO2 in the regulation of cerebral blood flow. Circ Res 20: 272–78PubMedCrossRefGoogle Scholar
  141. 140.
    Sganzerla EP, Bordone G (1979) Attività EEG alfa-simile nel coma dopo arresto cardiocircolatorio. Anestesia e Rianimazione 20: 267–275Google Scholar
  142. 141.
    Shapiro HM (1975) Intracranial hypertension. Therapeutic and anesthetic considerations. Anesthesiology 43: 445–71PubMedCrossRefGoogle Scholar
  143. 142.
    Shapiro HM, Galindo A, Wyte SR, Harris AB (1973) Rapid intraoperative reduction of intracranial pressure with thiopentone. Br J Anesth 45: 1057–1062CrossRefGoogle Scholar
  144. 143.
    Shapiro HM, Wyte SR, Loeser J (1974) Barbiturate augmented hypothermia for reduction of persistent intracranial hypertension. J Neurosurg 40: 90–100PubMedCrossRefGoogle Scholar
  145. 144.
    Siesjö BK (1978) Brain metabolism and anaesthesia. Acta Anaesthesiol Scand [Suppl] 70: 56–59Google Scholar
  146. 145.
    Simeone FA, Frazer G, Lawner P (1979) Ischemic brain edema: Comparative effects of barbiturates and hypothermia. Stroke 10: 8–12Google Scholar
  147. 146.
    Smith AL (1977) Barbiturate protection in cerebral hypoxia. Anesthesiology 47: 285–293PubMedCrossRefGoogle Scholar
  148. 147.
    Snyder BD, Ramirez-Lassepas M, Lippert DM (1977) Neurologic states and prognosis after cardiopulmonary arrest: 1. A retrospective study. Neurology 27: 807–811Google Scholar
  149. 148.
    Snyder BD, Ramirez-Lassepas M, Sukum AI (1978) Failure of pentothal to protect from anoxic cerebral injury. Stroke 9: 99Google Scholar
  150. 149.
    Snyder BD, Ramirez-Lassepas M, Sukum P, Fryd D, Sung JH (1979) Failure of thiopental to modify global anoxic injury. Stroke 10: 135–141PubMedCrossRefGoogle Scholar
  151. 150.
    Soloway M, Nadel W, Albin MS, White RJ (1968) The effect of hyperventilation on subsequent cerebral infarction. Anesthesiology 29: 975PubMedCrossRefGoogle Scholar
  152. 151.
    Steen PA, Soule EH, Michenfelder JD (1979) Detrimental effect of prolonged hypothermia in cats and monkeys with and without regional cerebral ischemia. Stroke 10: 522–529PubMedCrossRefGoogle Scholar
  153. 152.
    Subczynski J (1975) State of consciousness scoring system. J Neurosurg 43: 251PubMedGoogle Scholar
  154. 153.
    Teasdale G, Jennett B (1974) Assessment of coma and impaired consciousness. A practical scale. Lancet II: 81–84Google Scholar
  155. 154.
    Teasdale G, Jennett B (1976) Assessment and prognosis of coma after head injury. Acta Neurochir (Wien) 34: 45–55CrossRefGoogle Scholar
  156. 155.
    Teasdale G, Knill-Jones R, Van Der Sande J (1978) Observer variability in assessing impaired consciousness and coma. J Neurol Neurosurg Psychiatry 41: 603PubMedCrossRefGoogle Scholar
  157. 156.
    Thierry AM, Javoy F, Glowinsky J, Kety SS (1968) Effects of stress on the metabolism of norepinephrine, dopamine and serotonin in the central nervous system of the rat. I Modifications of norepinephrine turnover. J Pharmacol Exp Ther 163: 163–171Google Scholar
  158. 157.
    Thomassen A, S¢rensen K, Wernberg M (1978) The prognostic value of EEG in coma survivors after cardiac arrest. Acta Anaesthesiol Scand 22: 483–490CrossRefGoogle Scholar
  159. 158.
    Thomassen A, Wernberg M (1979) Prevalence and prognostic significance of coma after cardiac arrest outside intensive care and coronary units. Acta Anaesthesiol Scand 23: 143–148PubMedCrossRefGoogle Scholar
  160. 159.
    Toole JF, Barnes RW (1979) Neurological monitoring techniques. Stroke 10: 467–470Google Scholar
  161. 160.
    Trop D (1978) Effets métaboliques des barbituriques sur le cerveau anoxique: le piégeage des radicaux libres. Ann Anesthesiol Fr 19: 815–820PubMedGoogle Scholar
  162. 161.
    Vapalahti M, Troupp H (1971) Prognosis for patients with severe brain injuries. Br Med J iii:404–407Google Scholar
  163. 162.
    Willoughby JO, Leach BG (1974) Relation of neurological findings after cardiac arrest to outcome. Br Med J iii: 437–439Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1983

Authors and Affiliations

  • Marialuisa Bozza-Marrubini

There are no affiliations available

Personalised recommendations