[Clinical study of intracranial pressure and auditory brain stem response in the cases of diffuse axonal injury].
The course of intracranial pressure (ICP) and the finding of auditory brain stem response (ABR) was discussed in the cases diagnosed as diffuse axonal injury (DAI) established by Gennarelli. ICP was measured in twenty-six cases which were divided into three groups according to the course of ICP: Group (1), in which ICP remained below 20 mmHg (group I, 9 cases). Group (2), in which ICP rose above 20 mmHg but was controlled by therapy (group II, 8 cases). Group (3), in which ICP rose above 20 mmHg and could not be controlled by any therapies (group III, 9 cases). Glasgow outcome scale 3 months after the injury in the cases of group I and II was severe disability (SD) and/or persistent vegetative state (PVS), but all of the cases in group III died. The findings of serial ABR were divided into 3 groups. These were group A (2 cases) which showed normal record, group B (5 cases) which showed elongation of latencies between the first and fifth waves, and group C (5 cases) in which there was no response in ABR. GOS in group A or B was SD and/or PVS, but all of the cases in group C were shown to be dead in GOS. Our studies suggest that the level of ICP in DAI is rather higher than that published in previous reports, and the continuous measurements of ICP and serial records of ABR are useful for evaluating the outcome of DAI.
Yokota
H
H
Department of Emergency and Critical Care Medicine, Nippon Medical School.
Henmi
H
H
Mashiko
K
K
Yasuda
K
K
Otsuka
T
T
Kobayashi
S
S
Yajima
K
K
Nakazawa
S
S
D000293:Adolescent; D001369:Axons / Q000473:pathology; D001930:Brain Injuries / Q000473:pathology / Q000503:physiopathology*; D016057:Evoked Potentials, Auditory, Brain Stem; D015600:Glasgow Coma Scale; D006801:Humans; D007427:Intracranial Pressure; D008297:Male; D011379:Prognosis