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Alexa I Canady - One of the best experts on this subject based on the ideXlab platform.
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Limitations of the Glasgow Coma Scale in predicting outcome in children with traumatic brain injury.
The Journal of pediatrics, 1992Co-Authors: M W Lieh-lai, Andreas A Theodorou, Ashok P Sarnaik, Kathleen L Meert, Patricia M Moylan, Alexa I CanadyAbstract:To study the hypothesis that, in the absence of an ischemic-hypoxic state, children with severe traumatic brain injury and with unfavorable Glasgow Coma Scale scores may have good recovery. Retrospective, observational, cross-sectional study with factorial design. Inpatient population in a university hospital. Seventy-nine children with traumatic brain injury admitted to the intensive care unit. All patients received close monitoring and strict control of intracranial pressure (less than 20 mm Hg) and cerebral perfusion pressure (greater than 60 mm Hg). Admission Glasgow Coma Scale score, survival, need for cardiopulmonary resuscitation, presence of shock, peak intracranial pressure, duration of Coma, Glasgow Outcome Scale score, and the results of neuropsychologic tests were analyzed. Of 79 children, 70 (89%) survived. Although the mortality rate was higher among patients with Glasgow Coma Scale scores of 3 to 5, 14 (64%) of 22 of these children survived. Nonsurvivors had a significantly higher incidence of shock and need for cardiopulmonary resuscitation. Except for two patients who had prolonged hypoxemia, all children, including those with Glasgow Coma Scale scores of 3 to 5, had a satisfactory outcome (Glasgow Outcome Scale scores of 4 or 5). Neuropsychologic outcome was not significantly different in the survivors with Glasgow Coma Scale scores of 3 to 5 and those with Glasgow Coma Scale scores of 6 or more. A low Glasgow Coma Scale score does not always accurately predict the outcome of severe traumatic brain injury; in the absence of hypoxic-ischemic injury, children with traumatic brain injury and Glasgow Coma Scale scores of 3 to 5 can recover independent function.
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limitations of the Glasgow Coma Scale in predicting outcome in children with traumatic brain injury
The Journal of Pediatrics, 1992Co-Authors: Mary Liehlai, Andreas A Theodorou, Ashok P Sarnaik, Kathleen L Meert, Patricia M Moylan, Alexa I CanadyAbstract:Objective: To study the hypothesis that, in the absence of an ischemic-hypoxic state, children with severe traumatic brain injury and with unfavorable Glasgow Coma Scale scores may have good recovery. Design: Retrospective, observational, cross-sectional study with factorial design. Setting: Inpatient population in a university hospital. Patients: Seventy-nine children with traumatic brain injury admitted to the intensive care unit. Interventions: All patients received close monitoring and strict control of intracranial pressure ( 60 mm Hg). Measurements and results: Admission Glasgow Coma Scale score, survival, need for cardiopulmonary resuscitition, presence of shock, peak intracranial pressure, duration of Coma, Glasgow outcome Scale score, and the results of neuropsychologic tests were analyzed. Of 79 children, 70 (89%) survived. Although the mortality rate was higher among patients with Glasgow Coma Scale scores of 3 to 5, 14 (64%) of 22 of these children survived. Nonsurvivors had a significantly higher incidence of shock and need for cardiopulmonary resuscitation. Except for two patients who had prolonged hypoxemia, all children, including those with Glasgow Coma Scale scores of 3 to 5, had a satisfactory outcome (Glasgow Outcome Scale scores of 4 or 5). Neuropsychologic outcome was not significantly different in the survivors with Glasgow Coma Scale scores of 3 to 5 and those with Glasgow Coma Scale scores of 6 or more. Conclusions: A low Glasgow Coma Scale score does not always accurately predict the outcome of severe traumatic brain injury; in the absence of hypoxic-ischemic injury, children with traumatic brain injury and Glasgow Coma Scale scores of 3 to 5 can recover independent function.
Adnan Ceviz - One of the best experts on this subject based on the ideXlab platform.
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serum neuron specific enolase as a predictor of short term outcome and its correlation with Glasgow Coma Scale in traumatic brain injury
Neurosurgical Review, 2008Co-Authors: Aslan Guzel, Uygur Er, Mehmet Tatli, Ufuk Aluclu, Umit Ozkan, Yucel Duzenli, Omer Satici, Ebru Guzel, Serdar Kemaloglu, Adnan CevizAbstract:Elevated serum neuron-specific enolase levels are correlated with brain cell damage. Low scores according to Glasgow Coma Scale are also considered as serious poor prognostic factor. The aims of the study were to investigate whether there is a correlation between the two measurements in patients with traumatic brain injury and whether serum neuron-specific enolase levels have potential as a screening test to predict outcome. A total of 169 consecutive patients with traumatic brain injury admitted to our clinic between 2002 and 2005 are included in this study. Those patients, who had any major health problem before trauma, were excluded from the study. However, patients with isolated head injury were included in the study. Serial serum neuron-specific enolase concentrations taken at the first 2, 24, and 48 h after traumatic brain injury were analyzed. A computed tomography was performed on each patient on admission. Their Glasgow Coma Scale scores were recorded serially. The relationship between Glasgow Coma Scale scores and the serum neuron-specific enolase levels were assessed by statistical methods. There was a significant negative correlation between the serum neuron-specific enolase levels and Glasgow Coma Scale scores. The levels of neuron-specific enolase were significantly higher in the patients who died in 30 days after trauma and whose scores were lower than or equal to 8 points in Glasgow Coma Scale. Although there are several serious limitations of the use of neuron-specific enolase as a biomarker in traumatic brain injury (i.e., hypoperfusion, extracranial trauma, bleeding, liver, or kidney damage also increase the level of neuron-specific enolase), its concentrations may be useful as a practical and helpful screening test to identify neurotrauma patients who are at increased risk and may provide supplementary estimation with radiological and clinical findings.
John J Mcdonnell - One of the best experts on this subject based on the ideXlab platform.
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the prognostic value of the modified Glasgow Coma Scale in head trauma in dogs
Journal of Veterinary Internal Medicine, 2001Co-Authors: Simon Platt, Simona T Radaelli, John J McdonnellAbstract:A clinical Coma Scale modified from the Glasgow Coma Scale used for humans has been suggested as a useful predictor of outcome in the head trauma patient. The objective of this study was to correlate the modified Glasgow Coma Scale (MGCS) score of dogs with head trauma with their probability of survival. Thirty-eight dogs with head trauma were selected and retrospectively evaluated. The information retrieved from the medical record of each dog included signalment, body weight, cause of head trauma, MGCS, presence of concurrent neck pain, and outcome (dead or alive) after 48 hours. Logistic regression was used to model survival in the 1st 48 hours as a function of MGCS, gender, weight, and calvarial fractures. The MGCS ranged from 5 to 18. Seven dogs died within 48 hours of the head trauma. The MGCS could predict the probability of survival in the 1st 48 hrs after head trauma with 50% probability in a patient with a score of 8. Gender, weight, and presence of skull fractures did not predict survival. In conclusion, the MGCS is a useful index for prediction of outcome in dogs with head trauma.
Mary Liehlai - One of the best experts on this subject based on the ideXlab platform.
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limitations of the Glasgow Coma Scale in predicting outcome in children with traumatic brain injury
The Journal of Pediatrics, 1992Co-Authors: Mary Liehlai, Andreas A Theodorou, Ashok P Sarnaik, Kathleen L Meert, Patricia M Moylan, Alexa I CanadyAbstract:Objective: To study the hypothesis that, in the absence of an ischemic-hypoxic state, children with severe traumatic brain injury and with unfavorable Glasgow Coma Scale scores may have good recovery. Design: Retrospective, observational, cross-sectional study with factorial design. Setting: Inpatient population in a university hospital. Patients: Seventy-nine children with traumatic brain injury admitted to the intensive care unit. Interventions: All patients received close monitoring and strict control of intracranial pressure ( 60 mm Hg). Measurements and results: Admission Glasgow Coma Scale score, survival, need for cardiopulmonary resuscitition, presence of shock, peak intracranial pressure, duration of Coma, Glasgow outcome Scale score, and the results of neuropsychologic tests were analyzed. Of 79 children, 70 (89%) survived. Although the mortality rate was higher among patients with Glasgow Coma Scale scores of 3 to 5, 14 (64%) of 22 of these children survived. Nonsurvivors had a significantly higher incidence of shock and need for cardiopulmonary resuscitation. Except for two patients who had prolonged hypoxemia, all children, including those with Glasgow Coma Scale scores of 3 to 5, had a satisfactory outcome (Glasgow Outcome Scale scores of 4 or 5). Neuropsychologic outcome was not significantly different in the survivors with Glasgow Coma Scale scores of 3 to 5 and those with Glasgow Coma Scale scores of 6 or more. Conclusions: A low Glasgow Coma Scale score does not always accurately predict the outcome of severe traumatic brain injury; in the absence of hypoxic-ischemic injury, children with traumatic brain injury and Glasgow Coma Scale scores of 3 to 5 can recover independent function.
Aslan Guzel - One of the best experts on this subject based on the ideXlab platform.
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serum neuron specific enolase as a predictor of short term outcome and its correlation with Glasgow Coma Scale in traumatic brain injury
Neurosurgical Review, 2008Co-Authors: Aslan Guzel, Uygur Er, Mehmet Tatli, Ufuk Aluclu, Umit Ozkan, Yucel Duzenli, Omer Satici, Ebru Guzel, Serdar Kemaloglu, Adnan CevizAbstract:Elevated serum neuron-specific enolase levels are correlated with brain cell damage. Low scores according to Glasgow Coma Scale are also considered as serious poor prognostic factor. The aims of the study were to investigate whether there is a correlation between the two measurements in patients with traumatic brain injury and whether serum neuron-specific enolase levels have potential as a screening test to predict outcome. A total of 169 consecutive patients with traumatic brain injury admitted to our clinic between 2002 and 2005 are included in this study. Those patients, who had any major health problem before trauma, were excluded from the study. However, patients with isolated head injury were included in the study. Serial serum neuron-specific enolase concentrations taken at the first 2, 24, and 48 h after traumatic brain injury were analyzed. A computed tomography was performed on each patient on admission. Their Glasgow Coma Scale scores were recorded serially. The relationship between Glasgow Coma Scale scores and the serum neuron-specific enolase levels were assessed by statistical methods. There was a significant negative correlation between the serum neuron-specific enolase levels and Glasgow Coma Scale scores. The levels of neuron-specific enolase were significantly higher in the patients who died in 30 days after trauma and whose scores were lower than or equal to 8 points in Glasgow Coma Scale. Although there are several serious limitations of the use of neuron-specific enolase as a biomarker in traumatic brain injury (i.e., hypoperfusion, extracranial trauma, bleeding, liver, or kidney damage also increase the level of neuron-specific enolase), its concentrations may be useful as a practical and helpful screening test to identify neurotrauma patients who are at increased risk and may provide supplementary estimation with radiological and clinical findings.