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Non-traumatic coma--profile and prognosis
A K Thacker1, B N Singh, N B Sarkari
1BRD Medical College, Gorakhpur, 273013.
The Journal of the Association of Physicians of India
|April 1, 1997
Summary
Investigating non-traumatic coma causes in 200 patients revealed cerebrovascular diseases and CNS infections as leading factors. Poor outcomes correlate with low Glasgow Coma Scale (GCS) scores and absent brainstem reflexes.
Area of Science:
- Neurology
- Critical Care Medicine
Background:
- Non-traumatic coma presents a significant clinical challenge with diverse underlying etiologies.
- Understanding the causes and prognostic indicators is crucial for effective patient management.
Purpose of the Study:
- To determine the primary causes of non-traumatic coma in a consecutive patient cohort.
- To identify neurological factors associated with poor outcomes in non-traumatic coma.
Main Methods:
- A prospective investigation of 200 consecutive patients admitted with non-traumatic coma.
- Neurological assessment included Glasgow Coma Scale (GCS) scoring and evaluation of brainstem reflexes.
Main Results:
- Cerebrovascular diseases (33%), central nervous system (CNS) infections (21%), and hepatic encephalopathy (18%) were the most frequent causes.
- A significant association was found between poor outcomes (mortality or severe disability) and low GCS scores, absent pupillary, oculocephalic, and oculovestibular reflexes, and decerebrate posture.
Conclusions:
- Cerebrovascular diseases and CNS infections are leading causes of non-traumatic coma and are associated with poor prognosis.
- Absence of specific brainstem reflexes and low GCS scores are critical indicators of poor neurological outcome in non-traumatic coma.