Evaluation of brain function in severe human head trauma with multimodality evoked potentials. Part 2: Localization of brain dysfunction and correlation with posttraumatic neurological conditions.
Evaluation of brain function in severe human head trauma with multimodality evoked potentials. Part 2: Localization of brain dysfunction and correlation with posttraumatic neurological conditions.
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利用多模态诱发电位评估严重人类头部创伤的脑功能。
DOI：
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发表时间：
1977
影响因子：
4.1
通讯作者：
David J. Mayer
中科院分区：
文献类型：
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作者：
P. Richard;Greenberg;Donald P. Becicer;J. Miller;David J. Mayer
我们对51例严重头部外伤的昏迷患者进行了电生理检查，以定位脑功能障碍区域，并将功能障碍位点与患者创伤后神经系统状况联系起来。根据诱发电位数据，脱皮或失觉的存在取决于大脑半球功能障碍。由诱发电位定义的脑干功能障碍与姿势无关。另一方面，眼脑反应受损和双侧瞳孔光反应异常与脑干功能障碍相关，而半球功能障碍与两者无关：昏迷持续时间取决于半球功能障碍。脑干功能障碍与长时间昏迷无显著相关性。此外，在头部创伤后急性期（平均第3天）记录的I级或II级多模态脑损伤电位的头部创伤患者中，80%在损伤后30天内出现反应。分级体感觉脑损伤电位似乎是一个强大的预后工具，因为它们与患者的最终结果显著相关，即使在损伤后早期记录。异常的多模态诱发电位记录了昏迷患者的视觉、听觉和运动系统的异常，并且在诊断这些系统的持续局灶性缺陷方面比临床神经学检查更有效。
is Electrophysiological investigations were undertaken in 51 comatose patients with severe head trauma to locate areas of brain dysfunction and to relate the loci of dysfunction to the patient's posttraumatic neurological condition. On the basis of evoked potential data, the presence of decortication or decerebration depended on cerebral hemispheric dysfunction. Brain-stem dysfunction, defined by evoked potentials, did not correlate with posturing. On the other hand, impaired oculocephalic responses and bilateral abnormal pupillary light responses were associated with brainstem dysfunction, while hemispheric dysfunction did not correlate with either: Duration of coma was dependent on hemispheric dysfunction. Brain-stem dysfunction was not significantly associated with prolonged coma. Furthermore, 80% of the head trauma patients who had Grade I or II multimodality evoked brain-injury potentials recorded in the acute period following head trauma (mean Day 3) became responsive within 30 days of their injury. Graded somatosensory brain injury potentials appeared to be a powerful prognostic tool as they significantly correlated with the patient's final outcome even when recorded early after injury. Abnormal multimodality evoked potentials recorded acutely consistently defined dysfunction of the visual, auditory, and motor systems in comatose patients, and were considerably more effective than the clinical neurological examination in diagnosing persisting focal deficits of these systems.