[Modalities and delays in the resoration of consciousness after brain injury]

We studied the modalities and delays of restructuring of consciousness in a series of 89 consecutive survival cases, ranging over a large variety of age and severity and leading to any degree of awareness and results. We used the Glasgow coma scale, the study of brain-stem reflexes, and the Glasgow outcome scale. The recovery of awareness (eye opening to pain and fronto-orbicular reflex) was obtained mainly on the 9th day, with a limited variance. Recovery of a basic responsiveness to pain was concomittant of spontaneous eye opening mainly on the 15th day. A true relationship obeying orders was noticed on the 21st day, and a verbal response ranging mainly from the 30th day (confused) to the 60th (oriented). There was not any significative correlation of the delays with other early indicators of prognosis (Initial Glasgow score, C.T. scann lesions). Relating to the used sedation the effect was significant for the delays of eye opening only, with a possible analyse of the relationship. An inter-relationship between the steps and delays, leading to define an optimum for eye opening before day 15, for a motor response localizing pain before day 21, and for the item "obey to orders" before day 30 can be define as related to G.O.S. 4 and 5. A final analysis gave 79% of positive correlation with good results. We find a correlation between the delays of restructuring of consciousness and the functional results.