Poster 12: Post-Traumatic Amnesia Duration, Glasgow Coma Scale, and Intracranial Pressure Correlation: Evidence for Acute Management of Traumatic Brain Injury

PM&R ◽  
2017 ◽  
Vol 9 ◽  
pp. S132-S132
Author(s):  
Nhung Quach ◽  
Reza Ehsanian ◽  
Jyodi Mohole ◽  
Samantha Sechrist ◽  
Sarah Lavoie ◽  
...  
2007 ◽  
Vol 15 (4) ◽  
pp. 651-657 ◽  
Author(s):  
Silvia Cristina Fürbringer e Silva ◽  
Regina Marcia Cardoso de Sousa

Restrictions in the application of the Galveston Orientation and Amnesia Test and questionings about the relationship between conscience and post-traumatic amnesia motivated this study, which aims to identify, through the Glasgow Coma Scale scores, when to initiate the application of this amnesia test, as well to verify the relationship between the results of these two indicators. The longitudinal prospective study was carried at a referral center for trauma care in São Paulo - Brazil. The sample consisted of 73 victims of blunt traumatic brain injury, admitted at this institution between January 03rd and May 03rd 2001. Regarding the applicability, the test could be applied in patients with a Glasgow Coma Scale score > 12; however, the end of post traumatic amnesia was verified in patients who scored > 14 on the scale. A significant relationship (r s = 0.65) was verified between these measures, although different kinds of relationship between the end of the amnesia and changes in consciousness were observed.


Author(s):  
Rani Maria Yogipranata ◽  
Hermina Sukmani

CORRELATION BETWEEN OPTIC NERVE SHEATH DIAMETER AND MARSHALL CT SCORE WITH GLASGOW COMA SCALE IN TRAUMATIC BRAIN INJURYABSTRACTIntroduction: In traumatic brain injury (TBI), non-contrast brain CT scan is able to detect an increase in intracranial pressure, which is crucial in patient’s management. Optic nerve sheath diameter’s (ONSD) measurement is a new method that is expected to assess an increase in intracranial pressure noninvasively. Marshall CT score is a valid instrument, a de facto standard to classify head injury patient which correlates with an increased intracranial pressure.Aims: To see the correlation between ONSD and Marshall CT score with Glasgow Coma Scale (GCS).Methods: This was a retrospective, analytic observational with cross-sectional research’s design taken from the patients’ medical record admitted in Dr. Kariadi Hospital, Semarang, between March-August 2017. Measurement of ONSD and Marshall CT score were done by a radiologist. Rank Spearman’s were used to assess the correlation between variables.Results: There were 34 subjects, the majority were man (67,6%), with highest incidents in less than 30 years age (41,2%) and mostly caused by accident  (76,4%). Statistical analysis showed a moderate negative degree correlation between ONSD and Marshall CT score with GCS.Discussion: Enlargement of ONSD and higher Marshall CT score were correlated negatively related with the GCSin TBI patients with increased intracranial pressure.Keywords: Glasgow Coma Scale, Marshall CT score, optic nerve sheath diameter’s, traumatic brain injuryABSTRAK Pendahuluan: Pada cedera kepala atau traumatic brain injury (TBI), penggunaan CT scan kepala tanpa kontras dapat mendeteksi tanda-tanda peningkatan tekanan intrakranial (TIK), yang penting bagi tata laksana pasien. Sementara pengukuran diameter optic nerve sheath yang disebut optic nerve sheath diameter (ONSD) merupakan metode baru yang diharapkan dapat menilai peningkatan tekanan intrakranial secara non-invasif. Marshall CT score merupakan instrumen valid dan menjadi standar de facto dalam mengklasifikasikan pasien cedera kepala yang berkorelasi dengan peningkatan TIK.Tujuan: Untuk melihat adanya korelasi antara diameter N. Optikus dan Marshall CT score dengan Skala KomaGlasgow (Glasgow Coma Scale/GCS).Metode: Penelitian analitik observasional retrospektif secara potong lintang dari data rekam medis pasien cedera kepala dewasa yang dirawat di RSUP Prof. Dr. Kariadi, Semarang, pada bulan Maret-Agustus 2017. Selanjutnya kesemua subjek dilakukan pengukuran ONSD pada kedua mata serta penilaian Marshall CT score oleh seorang spesialis radiologi. Dilakukan uji korelasi Rank Spearman’s untuk menilai ketiga parameter tersebut.Hasil: Terdapat 34 subjek yang terutama laki-laki (67,6%) dengan usia terbanyak <30 tahun (41,2%) dan penyebab terbanyak adalah kecelakaan (76,4%). Didapatkan korelasi negatif derajat sedang antara ONSD dan Marshall CT score dengan GCS.Diskusi: Peningkatan diameter optic nerve sheath dan Marshall CT score berkorelasi dengan penurunan skor GCSpada pasien cedera kepala yang mengalami peningkatan TIK.Kata kunci: Cedera kepala, diameter optic nerve sheath, Marshall CT score, Skala Koma Glasgow


2021 ◽  
Vol 11 (8) ◽  
pp. 1044
Author(s):  
Cristina Daia ◽  
Cristian Scheau ◽  
Aura Spinu ◽  
Ioana Andone ◽  
Cristina Popescu ◽  
...  

Background: We aimed to assess the effects of modulated neuroprotection with intermittent administration in patients with unresponsive wakefulness syndrome (UWS) after severe traumatic brain injury (TBI). Methods: Retrospective analysis of 60 patients divided into two groups, with and without neuroprotective treatment with Actovegin, Cerebrolysin, pyritinol, L-phosphothreonine, L-glutamine, hydroxocobalamin, alpha-lipoic acid, carotene, DL-α-tocopherol, ascorbic acid, thiamine, pyridoxine, cyanocobalamin, Q 10 coenzyme, and L-carnitine alongside standard treatment. Main outcome measures: Glasgow Coma Scale (GCS) after TBI, Extended Glasgow Coma Scale (GOS E), Disability Rankin Scale (DRS), Functional Independence Measurement (FIM), and Montreal Cognitive Assessment (MOCA), all assessed at 1, 3, 6, 12, and 24 months after TBI. Results: Patients receiving neuroprotective treatment recovered more rapidly from UWS than controls (p = 0.007) passing through a state of minimal consciousness and gradually progressing until the final evaluation (p = 0.000), towards a high cognitive level MOCA = 22 ± 6 points, upper moderate disability GOS-E = 6 ± 1, DRS = 6 ± 4, and an assisted gait, FIM =101 ± 25. The improvement in cognitive and physical functioning was strongly correlated with lower UWS duration (−0.8532) and higher GCS score (0.9803). Conclusion: Modulated long-term neuroprotection may be the therapeutic key for patients to overcome UWS after severe TBI.


2015 ◽  
Vol 96 (5) ◽  
pp. 956-959 ◽  
Author(s):  
Susanne Meares ◽  
E. Arthur Shores ◽  
Tracy Smyth ◽  
Jennifer Batchelor ◽  
Margaret Murphy ◽  
...  

Author(s):  
Ruchir Gupta

In this chapter the essential aspects of anesthesia for traumatic brain injury are discussed. Subtopics include manifestations and treatment of elevated intracranial pressure (ICP), Glasgow Coma Scale (GCS), drugs used to lower ICP, and patient monitoring. The case presented is an emergent craniotomy. The chapter is divided into preoperative, intraoperative, and postoperative sections with important subtopics related to the main topic in each section. Preoperative topics discussed are evaluation of trauma, use of the GCS in this case, assessing intracranial hypertension, history of substance abuse, and clearing the cervical spine. Issues related to intraoperative management in this case include induction and use of blood products. Postoperative concerns addressed include polyuria and acute respiratory distress syndrome.


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