Glasgow Coma Score

Stroke patients who require mechanical ventilation are not necessarily destined for a poor outcome. In a study by Santoli et al., 58 patients underwent mechanical ventilation and 16 survived. Eleven achieved a Barthel Index (BI) score of 60, indicating a good outcome. Within this study population, those patients with bilaterally absent comeal and pupillary reflexes had uniformly poor outcomes, underscoring the need for careful assessment of brainstem reflexes in intubated stroke patients. Other factors that have been associated with poor outcome in intubated stroke patients are advanced age and lower Glasgow Coma Score (GCS) at the time of intubation, as well as seizures and pulmonary edema. ... 

Adult Injury Saverity Measures (Glasgow Coma Score and Revised Trauma Score)... 

In clinical studies, posttraumatic hypothermia has also been reported to be beneficial (7,18). Marion et al. (18) demonstrated that posttraumatic hypothermia (32-33°C/24 h) in patients with severe TBI and Glasgow Coma Scores of 5-7 on admission hastened neurologic recovery and may have improved outcome. These clinical findings are impor-... 

A 41-year-old man jumped through a ground-floor window after cocaine abuse. His Glasgow coma score was 7/15. His temperature was 40°C, heart rate 140/ minute, and respiratory rate 40/minute. He had a tonic-clonic seizure and was intubated and ventilated. Blood chemistry showed a profound metabolic acidosis (pH 7.19), a raised creatinine at 232 pmol/l, a raised... 

The aims of management are to identify the cause of the SAH, to treat the source of the bleeding to prevent recurrence, to prevent the general complications of stroke and to manage the complications of SAH (Vermeulen et al. 1992 Wijdicks 1995). Close monitoring using the Glasgow Coma Score and pupillary responses as well as for the development of focal deficits is required. 

A 51-year-old woman took 87 tablets of carisoprodol (350 mg each) over 13 days and developed lethargy and abnormal speech. She was confused and her Glasgow Coma Score was 9/15. Her pupils were small and reactive. Two boluses of naloxone 2 mg were administered with no effect. After flumazenil 0.2 mg she became more alert but was still mildly somnolent. After a second dose of flumazenil 0.2 mg all signs of intoxication... 

For example, patients with acute head injury and a low Glasgow Coma Score have a dismal prognosis, and therapeutic interventions (if ever likely to be successful) must be instituted quickly. Under these conditions, there is often not even the time to find relatives to provide surrogate informed consent. Even if relatives can be found quickly enough, then their emotional state may not be suited to becoming truly informed before giving consent. 

For the purpose of the analysis, lactate concentrations were assumed be pseudosteady-state at the beginning of the first DCA dose, so that A i was set to equal the lactate concentration at time 0 multiplied by the estimated A out (A m= A out lactate). A link between the 24 hour post-trauma CSF lactate and 6 month postinjury Glasgow Coma Score (GCS) was also estimated by application of logistic regression to literature data (20). Thus, a PK-exposure-PD-CSF lactate-outcomes model was constructed with the biomarker, CSF lactate, in the center. It must be recognized that this modeling and evaluation of power and efficiency could not be executed without a biomarker. 

Moulton C, Pennycook AG (1994) Relation between Glasgow coma score and cough reflex. Lancet... 

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