The prognostic reliability of the Glasgow coma score in traumatic brain injuries: evaluation of MRI data

European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society
D WoischneckT Kapapa

Abstract

To clarify the predictive power of the Glasgow coma score (GCS) after traumatic brain injury (TBI) and in the context of brain stem lesions. In 143 patients who had suffered severe TBI, the GCS was correlated to brain damage as visualized by cranial magnetic resonance imaging (MRI). This technique evaluates the damage to the brain stem in particular. The Brussels coma score (BCS) was also used. The GCS was not significantly correlated to brain stem lesions when it was only scored at the time of admission. When MRI was not used later on, the GCS showed a poor ability to predict the outcome. After 24 h, and on the day of MRI screening, the GCS was significantly correlated with two parameters: outcome (the higher the GCS, the better the outcome) and the frequency of patients without injuries to the brainstem in MRI (the higher the GCS, the higher this frequency). These correlations were much more evident when the BCS was used. The prognostic power of the GCS was found to vary over time; for example: a GCS of 3 at admission was associated with a favorable prognosis; a GCS of 4 signified a poor prognosis, irrespective of the time point at which the GCS was scored; and the prognostic power of a GCS of 5 deteriorated from the day of t...Continue Reading

References

Mar 1, 1975·Lancet·B Jennett, M Bond
Jan 1, 1976·Acta neurochirurgica·R A Frowein
Jul 13, 1974·Lancet·G Teasdale, B Jennett
Aug 8, 1981·British Medical Journal·D Gentleman, G Teasdale
Jan 1, 1982·Scottish Medical Journal·G Teasdale, D Gentleman
Jun 1, 1997·Neurological Research·D WoischneckH Dietz
Jun 23, 2000·The Journal of Emergency Medicine·G L Sternbach
Jul 20, 2001·Acta neurochirurgica·R FirschingB Peters
Mar 7, 2002·Neurological Research·Raimund FirschingWilfried Döhring
Jun 5, 2004·The Journal of Trauma·Pascal UdekwuDale Oller
Feb 1, 2007·Journal of Neurotrauma·Richard J MannionPeter J Hutchinson
Nov 6, 2007·Critical Care : the Official Journal of the Critical Care Forum·Nicolas WeissLouis Puybasset
Oct 10, 2008·Journal of Neurotrauma·Nicholas R GallowayAndré Obenaus
Dec 17, 2008·Injury·Krishanu ChaudhuriJeffrey V Rosenfeld
Feb 14, 2009·Neurological Research·Dieter WoischneckRaimund Firsching
Mar 31, 2009·Journal of Neurosurgery·Roukoz B ChamounShankar P Gopinath

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