Resuscitation treatment of the different degrees of unconsciousness

Ml, Bozza-Marrubini

doi:10.1007/bf01402103

Cited by 17 publications

(3 citation statements)

References 30 publications

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“…The relationship of fatalities in patients with extensor postural abnormal-FIG. 10. Mortality rate (cross-hatched areas) in the total group of severe head injuries and according to motor signs.…”

Section: Outcomementioning

confidence: 99%

Decerebrate rigidity in acute head injury

Bricolo¹,

Turazzi²,

Alexandre³

et al. 1977

Journal of Neurosurgery

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A comprehensive study of the motor patterns, usually grouped under the heading "decerebrate rigidity," was carried out in a series of 800 patients with severe head injuries. The incidence of these manifestations was 39.6%, and when they were present chances of survival were reduced from 79.4% to 28.1%. Clinical and electromyographic investigations revealed heterogeneous and unstable motor manifestations that did not fit into the classical groups of experimental models of decerebrate rigidity. Combinations of extensor and flexor attitudes and/or responses were frequently found in same patient, but could be separated into homogeneous groups. Each recognized postural pattern had its own distinct neurological signs and prognosis. Age did not significantly affect the outcome, however, intracranial exapnding lesions (73.5%), impairment of the brain-stem oculomotor system (49.8%), and deep coma (88.9%) all contributed to an unfavorable course. Surgical treatment was effective when performed for intracranial hematomas and in patients with incomplete extensor rigidity. Good recovery was achieved in 16% of decerebrate patients, while 12.1% survived in prolonged coma or with severe disabilities. All clinical and neuropathological data suggest that extensor motor abnormalities in the acute phase of cerebral traumatic disease do not always conclusively indicate structural brain-stem damage. A critical analysis of so-called "decerebrate rigidity" (rejecting in some instances its Sherringtonian implications) may allow for a more accurate clinical assessment of the severity of head injury.

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Section: Outcomementioning

confidence: 99%

Decerebrate rigidity in acute head injury

Bricolo¹,

Turazzi²,

Alexandre³

et al. 1977

Journal of Neurosurgery

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“…Other authors prefer to quantify some of the responses given by patients in coma to specific stimuli, such as pain or verbal stimuli, grading them in various levels or degrees of impairment of consciousness (Fischgold and Mathis, 1959;Bozza-Marrubini, 1964;Teasdale and Jennett, 1974).…”

mentioning

confidence: 99%

Blink reflexes in severe traumatic coma.

Buonaguidi¹,

Rossi²,

Sartucci³

et al. 1979

Journal of Neurology, Neurosurgery & Psychiatry

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“…Among the different approaches towards a classification of coma (Regan and Browne-Mayers, 1956;Fischgold and Mathis, 1959;Jouvet, 1965;Marrubini, 1965;Paillas et al, 1965;Bauer, 1966;Gulbrandsen et al, 1972;Demedts and Pillen, 1973;Teasdale and Jennett, 1974) two types of classification may be distinguished. One approach is based on systematic neurological examination with the purpose of correlating neurological symptoms and the implicit morphological substrate with loss of consciousness (Fisher, 1969;Plum and Posner, 1972).…”

mentioning

confidence: 99%

The Munich Coma Scle (MCS).

Brinkmann¹,

Cramon²,

Schulz³

1976

Journal of Neurology, Neurosurgery & Psychiatry

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SYNOPSISThe level of coma can be measured by the assessment of changes of behaviour after different intensities of stimulation. Two additive scales (Guttman scales) for susceptibility to stimulation and reactivity were developed, constituting the Munich Coma Scale (MCS). The findings of previous investigations were repeated in a new sample of 67 comatose patients. Implications of the additivity of reactivity are discussed and related to the concept of 'behavioural arousal' advanced in the recent literature.The states of severe disturbances ofconsciousness are often referred to as 'coma', although, strictly speaking, the word 'coma' refers to a state of complete loss of consciousness from which a patient cannot be aroused even by powerful stimulation.2 Nevertheless, 'coma' has been widely used to indicate different gradations of disturbances of consciousness. In this article 'coma' is used in this rather general sense.Among the different approaches towards a classification of coma (Regan and BrowneMayers, 1956;Fischgold and Mathis, 1959;Jouvet, 1965;Marrubini, 1965;Paillas et al., 1965;Bauer, 1966;Gulbrandsen et al., 1972;Demedts and Pillen, 1973;Teasdale and Jennett, 1974) two types of classification may be distinguished. One approach is based on systematic neurological examination with the purpose of correlating neurological symptoms and the implicit morphological substrate with loss of consciousness (Fisher, 1969;Plum and Posner, 1972). The other approach is based on the fact that the loss ofconsciousness, the most important feature common to all comatose patients, is correlated with the behavioural aspects of the patients (Gulbrandsen et al., 1972;. In this instance, the depth of un- responsiveness is determined by the assessment of behavioural responses to stimuli of different intensity. Both types of classification were combined into a single scheme by Jouvet (1965). The following study is based on the latter approach to classification of comatose states. In a previous study four non-verbal, physical stimuli were selected out of an initial set of 10 stimuli, as these cover the whole spectrum of comatose patients quite satisfactorily and form an additive (Guttman) scale (v. Cramon et al., 1975). A catalogue of some 59 stimulus-bound changes of behaviour at the outset of our experiments could be summarized into four types of reactions, which also form an additive scale.It is the aim of this paper to repeat our experiments with a new sample, the hypothesis being that the reduced set of stimuli and the condensed form of subsequent reactions will give the same results as in the previous study. It is also hypothesized that the additive structure of the two scales is maintained. METHODSSUBJECTS Sixty seven patients with clinically presumed or diagnosed disturbance of attention were examined. Forty six of these were suffering from neurological diseases; 21 were intoxicated from self-poisoning in the course of suicide attempts.

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Resuscitation treatment of the different degrees of unconsciousness

Cited by 17 publications

References 30 publications

Decerebrate rigidity in acute head injury

Decerebrate rigidity in acute head injury

Blink reflexes in severe traumatic coma.

The Munich Coma Scle (MCS).

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