Assessment and prognosis of coma after head injury

  title={Assessment and prognosis of coma after head injury},
  author={Graham M. Teasdale and Bryan Jennett},
  journal={Acta Neurochirurgica},
SummaryThe 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… Expand

Paper Mentions

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ConditionsTraumatic Brain Injury
[Glasgow Coma Scale in traumatic brain injury].
The Glasgow Coma Scale consists of three components, the ocular, motor and verbal response to standardized stimulation, and is used as a severity of illness indicator for coma of various origins. Expand
Development of Glasgow Coma and Outcome Scales
These scales were developed primarily to facilitate the assessment and recording of initial severity of brain dysfunction and of ultimate outcome in a multicenter study of outcome after severe brainExpand
The FOUR Score Predicts Outcome in Patients After Traumatic Brain Injury
The FOUR score is an accurate predictor of outcome in TBI patients and it has some advantages over GCS, such as all components of F Four score but not GCS can be rated in intubated patients. Expand
A Review of the Predictive Ability of Glasgow Coma Scale Scores in Head‐Injured Patients
  • M. McNett
  • Medicine
  • The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses
  • 2007
GCS scores are most accurate at predicting outcome in head‐injured patients when they are combined with patient age and pupillary response and when broad outcome categories are used, and better prediction occurs with very high or very low GCS scores. Expand
FOUR Score Predicts Early Outcome in Patients After Traumatic Brain Injury
Having similar predictive power of mortality compared to the GCS and APACHE II, the FOUR score can be used as an alternative in the prediction of early mortality in TBI patients in the ICU. Expand
Problems of the Glasgow Coma Scale with early intubated patients
The analysis of a well-defined group of German trauma patients with moderate and severe head injuries shows that low Glasgow Coma Scores established during the first two posttraumatic days must not correspond directly to the outcome after one year. Expand
The FOUR Score and GCS as Predictors of Outcome After Traumatic Brain Injury
FOUR is comparable to GCS in terms of predictive ability for functional status, cognitive outcome 3 months post-injury, and in-hospital mortality. Expand
Outcome following head injuries in the aged
It seems futile to use limited intensive treatment resources for an acute brain injury in a patient over 70 years of age who is unconscious on admission, but subacute and chronic subdural haematomas should be operated on promptly in spite of severe neurological impairment or advanced age. Expand
The Glasgow Coma Scale (GCS): Deciphering the Motor Component of the GCS
The aim of this article is to illustrate the need for clear, common language to describe the patient’s motor response to a painful stimulus post head injury, to avoid communication breakdown between healthcare professionals. Expand
Prediction of Outcome at Discharge From Acute Care Following Traumatic Brain Injury
Logistic regressions showed that a shorter posttraumatic amnesia decreased the probability of moderate to severe disability and can help predict rehabilitation needs upon discharge from an acute care hospital. Expand


Prognosis after head injury based on early clinical examination.
Results indicate that early clinical examination can reveal important prognostic information after head injury, and abnormal motor activity was the most important unfavourable sign, while for older patients it was unconsciousness. Expand
Abstract Persisting disability after brain damage usually comprises both mental and physical handicap. The mental component is often the more important in contributing to overall social disability.Expand
Assessment of outcome after severe brain damage.
Persisting disability after brain damage usually comprises both mental and physical handicap. The mental component is often the more important in contributing to overall social disability. Lack of anExpand
Clinical course and prognosis of acute post-traumatic coma.
The clinical course and prognosis of 282 cases of acute post-traumatic coma have been studied and it is believed it is possible to predict the final outcome of the patient by using the indices of age, level of coma, and the nature of the intracranial lesions. Expand
Assessment of coma and impaired consciousness. A practical scale.
A clinical scale has been evolved for assessing the depth and duration of impaired consciousness and coma that facilitates consultations between general and special units in cases of recent brain damage, and is useful also in defining the duration of prolonged coma. Expand
It is concluded that in patients over 60 no special or heroic methods of treatment are indicated but that in children and adolescents every effort should be made as long as there has not been respiratory arrest and cerebral death. Expand
Primary focal impact damage to the brainstem in blunt head injuries. Does it exist?
Serial blocks of brainstem from 100 fatal, blunt (non-missile) head injuries have been examined histologically and it is suggested that so-called " primary brainstem injury does not exist in isolation but is only an aspect of diffuse brain damage. Expand
Proceedings: Eye movements and brain-stem dysfunction after head injury.
  • G. Teasdale, J. Smith
  • Psychology, Medicine
  • Journal of neurology, neurosurgery, and psychiatry
  • 1975
It was suggested that orbital decompression might be considered more frequently than is often the case in view of its success in relieving discomfort in a high proportion of cases. Expand
The diagnosis of stupor and coma.
The third edition retains its approach to that art of diagnosis based on the understanding of pathophysiology and pathobiochemistry, but the authors have included new references and illustrations. Expand
An evaluation of the reliability and validity of the plantar response in a psychogeriatric population
The reproducibility of the reflex was so low that its clinical value in the elderly patient is seriously questioned and neither medication, age within the group, nor an organic as opposed to a functional diagnosis was related to this unreliability. Expand