Neunzig H P, Kunze K
Fortschr Neurol Psychiatr. 1987 Jul;55(7):223-30. doi: 10.1055/s-2007-1001824.
The practical employment of diagnostic and therapeutic management in the early stage of head-injured patients depends on the precise assessment of the clinical course. In a retrospective study of 39 patients with severe head injury the prognostic value of clinical and methodical (instrument) parameters was analysed and compared with results of 28 international studies. As findings of this study the factors "age", "motoric response", "pupillary light reaction" and "type of intracranial lesion" were combined with the highest precision of outcome prediction. On the other hand, signs originating from the autonomic nervous system were not useful to predict the clinical course. The duration of post-traumatic coma was not appropriate to give an early view of the development of disease. The high value of neurological state in combination with neuroradiological and neurophysiological investigations in the early posttraumatic period of severe head injury is emphasised.
颅脑损伤患者早期诊断与治疗管理的实际应用取决于对临床病程的精确评估。在一项对39例重度颅脑损伤患者的回顾性研究中,分析了临床和方法学(仪器)参数的预后价值,并与28项国际研究的结果进行了比较。作为本研究的结果,“年龄”“运动反应”“瞳孔对光反应”和“颅内病变类型”等因素在预测预后方面具有最高的准确性。另一方面,自主神经系统产生的体征对预测临床病程并无帮助。创伤后昏迷持续时间不足以早期了解疾病的发展情况。强调了在重度颅脑损伤创伤后早期,神经状态与神经放射学和神经生理学检查相结合的重要价值。