title: [Comas in the emergency room of a central hospital].
abstract: The aim of the present prospective work was to study the etiologic diagnosis and prognosis of the comatose patients for whom a neurologic examination is requested. It included 148 consecutive cases admitted to the emergency room of a general hospital. Coma was caused by supratentorial lesions in 38%, subtentorial lesions in 10%, diffuse or metabolic brain dysfunction in 49%, and psychiatric disorder in 1% of the patients. CT scan was the most valuable ancillary exam, modifying the initial etiologic diagnosis in 42% of the cases on whom it was performed. Seventy percent of the patients died. Coma caused by structural lesions had a worse outcome than coma caused by diffuse or metabolic brain dysfunction (intoxications excluded), and this type of coma had a worse outcome than drug-induced coma. The presence of anisocoria, the number of brainstem reflexes present and the pattern of motor response, as well as the Glasgow Coma Scale score, predicted the outcome.
authors.affiliation: Centro de Estudos Egas Moniz, Hospital de Santa Maria, Lisboa.
authors.forename: A
authors.initials: A
authors.lastname: De Mendonça
authors.forename: T P
authors.initials: TP
authors.lastname: Melo
authors.forename: M
authors.initials: M
authors.lastname: Crespo
authors.forename: J M
authors.initials: JM
authors.lastname: Ferro
mesh_terms: D000328:Adult; D000368:Aged; D003128:Coma / Q000209:etiology*; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies
vernacular_title: Comas na urgência de um hospital central.