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Prognosis of Patients with Severe Head Injury
487
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1979
Year
Traumatic Brain InjuryNeuropsychologyHead InjuryMotor Response PatternCognitive RehabilitationFacial TraumaSevere Head InjuryBrain Injury RehabilitationSocial SciencesStroke RehabilitationIntracranial PressureBrain InjuryNeurologyNeurorehabilitationNeuropathologyBrain DysfunctionMedicineRehabilitationRapid Trauma AssessmentFunctional RecoveryNeuroscienceConcussionStrokeBrain Dysfunction Changes
Brain dysfunction changes rapidly after injury, so outcome predictions are more reliable when based on the best early functioning level. The study analyzed 1,000 patients to examine how early clinical features of brain dysfunction predict 6‑month outcomes. Depth of coma, pupil reaction, eye movements, motor response pattern, and age are the most reliable predictors; very early assessments are often unduly pessimistic, but individualized predictions from a large database are a powerful tool for evaluating treatment efficacy.
The relationship between clinical features of brain dysfunction in the first week after severe head injury and outcome 6 months later has been analyzed for 1000 patients. Depth of coma, pupil reaction, eye movements, and motor response pattern, and patient age prove to be the most reliable predictors. The degree of brain dysfunction changes markedly soon after injury, and more reliable predictions of outcome result when assessment is based on the best level of functioning recorded in each early epoch. Predictions based on very early assessment are, therefore, often unduly pessimistic. Individual predictions of outcome, based on a large data bank, provide a powerful tool for assessing the relative efficacy of alternative treatments.