Prognostic Value of the Caloric-Vestibular Test in the Unconscious Patient With Cranial Trauma

Poulsen, J.C. Navarro; Zilstorff, K.

doi:10.1111/j.1600-0404.1972.tb07550.x

Cited by 27 publications

(5 citation statements)

References 18 publications

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“…Patients who are comatose from drug intoxication (Bender et al, 1955;Nathanson et al, 1957) or metabolic encephalopathy (Silberpfennig, 1938;Plum and Posner, 1972) may lose vestibulo-ocular eye movements; recovery of these movements in those who survive is evidence against structural brain-stem damage. In patients who are comatose from other causes, absence of vestibulo-ocular eye movements has been cited as a sign of irreversible brain-stem damage and impending death (Rodriquez Barrios, 1966;Poulsen and Zilstorff, 1972).…”

Section: Casementioning

confidence: 99%

Absent vestibulo-ocular reflexes and acute supratentorial lesions

Rosenberg

Sharpe

Hoyt

1975

Journal of Neurology, Neurosurgery & Psychiatry

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Section: Casementioning

confidence: 99%

Absent vestibulo-ocular reflexes and acute supratentorial lesions

Rosenberg

Sharpe

Hoyt

1975

Journal of Neurology, Neurosurgery & Psychiatry

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“…Spontaneous and induced eye movements are of prognostic value in patients with severe head injuries (Mingrino et al, 1965;Fisher, 1969;Poulsen and Zilstorff, 1972;Teasdale and Smith, 1975;Bricolo et al, 1977).…”

mentioning

confidence: 99%

Interobserver agreement in assessment of ocular signs in coma.

Berge¹,

Schouten²,

Boomstra³

et al. 1979

Journal of Neurology, Neurosurgery & Psychiatry

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SUMMARY There is interobserver agreement in the assessment of various ocular signs found in coma patients. As measure for observer agreement the parameter kappa (K) was determined for (in-)equality of pupils, reaction of pupils, spontaneous eye movements, and oculocephalic responses. The agreement in the assessment of the pupils to light and in the assessment of (in-)equality of pupils appeared to be satisfactory, but more disagreement occurred in assessing spontaneous eye movements and oculocephalic responses.

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“…Changes in the caloric vestibulo-ocular responses in patients with changed consciousness have been described by several authors (Nathanson et al 1957, Blegvad 1962, Mingrino et al 1965, l%odriguez Barrios, Bottinelli and Medoe 1966, Poulsen and Zilstorff 1972. Along with an increasing degree of disturbed consciousness the following changes were found successively: nystagmus, slow deviation of the eyes alone, slow dissociated eye movements in which the adducted eye usually remains behind, and finally, no response at all.…”

Section: Discussionmentioning

confidence: 86%

On the nature of brain stem disorders in severe head injured patients

1976

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The results of electro-oculographic recordings made after caloric vestibular stimulation (C.O.G.) in severe head injured patients are discussed. It was found that: 1. The C.O.G. correlates with the state of consciousness of the patients. 2. The rate of improvement of the C.O.G. correlates with the rate of the clinical improvement. 3. A prediction of the duration of unconsciousness can be made by repeated C.O.G. scores as well as by repeated scoring of the clinical state. 4. In all patients a paradoxical response is present except in those who have regained clear consciousness and in those persisting in a vegetative state, so the presence of a paradoxical response indicates the possibility of further improvement. It was supposed that in patients with a paradoxical response a functional brain dysfunction was present, which was at least partly caused by disturbed neurotransmitter metabolism. Therapeutic trials with L-DOPA and physostigmine were successful in patients with a paradoxical response, but without any result in those without this phenomenon. The responses to L-DOPA and to physostigmine are related respectively to motor pattern and to verbal or non-verbal communication.

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Prognostic Value of the Caloric-Vestibular Test in the Unconscious Patient With Cranial Trauma

Cited by 27 publications

References 18 publications

Absent vestibulo-ocular reflexes and acute supratentorial lesions

Absent vestibulo-ocular reflexes and acute supratentorial lesions

Interobserver agreement in assessment of ocular signs in coma.

On the nature of brain stem disorders in severe head injured patients

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