[Clinical aspects and prognosis following severe craniocerebral trauma]

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.