| Popis: |
Summary After studying 85 patients with severe traumatic coma and reviewing the published literature, the authors propose a simple clinical procedure for the diagnostic of such cases. This classification is based on signs without any ambiguity, easily recognized by different physicians, and of pathognomonic significance. These include reaction to pain, testing four reflexes integrated at different levels in the brain stem, pupil morphology, and spontaneous ocular movements. The clinical features corresponding fo different levels of dysfunction in the brain stem are described and their characteristics outlined. The importance of motor reactivity to pain associated to the brain stem reflexes (fronto-orbicular, photomotor, horizontal and vertical oculo-encephalic) is stressed. |
