[Evoked potentials in the follow-up and prognosis of patients with craniocerebral trauma].
The aims of this study were to find a reliable way of establishing the prognosis for the final outcome in the first week after head injury, to show the correlation between abnormalities in evoked potentials (EP) and clinical coma score, and finally, to document EP results in patients with the clinical diagnosis of brain death. We examined 46 patients, 23 in different states of coma and 23 with bulbar syndrome (complete absence of cortical and brain stem function). In the group of comatose patients brain stem auditory EP (BAEP) and somatosensory EP (SEP) were recorded in the first 48 h, 3-5 days, 1 week and 4 weeks after the head injury. The depth of coma was scaled with a scoring system devised by the authors and with the Innsbruck coma scale. Outcome was evaluated with the Glasgow outcome scale after 3, 6, and 9 months. BAEP were recorded bilaterally after stimulation with clicks; SEP were recorded from the neck (C2) and the contralateral cortex (C3', C4') after electrical stimulation of the median nerve. Evoked potentials were scored according to a four-point scale from grade 1 (normal) to grade 4 (only component I present in BAEP or absence of cortical responses on both sides in SEP). We found a significant correlation between the mean SEP score of the first week and the Glasgow outcome of the 3rd month, but no significant correlation between the BAEP score of the first week and the Glasgow outcome. There was a significant correlation between SEP (BAEP) scores and the corresponding clinical score.(ABSTRACT TRUNCATED AT 250 WORDS)
Zeitlhofer
J
J
Neurologische Universitätsklinik, Wien.
Steiner
M
M
Zadrobilek
E
E
Häusl
E
E
Sporn
P
P
Asenbaum
S
S
Oder
W
W
Baumgartner
C
C
Deecke
L
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D001926:Brain Death / Q000175:diagnosis; D001930:Brain Injuries / Q000175:diagnosis / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D003128:Coma / Q000175:diagnosis / Q000503:physiopathology; D005072:Evoked Potentials, Auditory; D005073:Evoked Potentials, Somatosensory; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis
Evozierte Potentiale zur Verlaufs- und Prognosebeurteilung von Schädel-Hirn-Trauma-Patienten.