Assessment of coma

References

Key articles

Nakagawa TA, Ashwal S, Mathur M, et al. Guidelines for the determination of brain death in infants and children: an update of the 1987 task force recommendations-executive summary. Ann Neurol. 2012 Apr;71(4):573-85. Abstract

Matthes G, Bernhard M, Kanz KG, et al. Emergency anesthesia, airway management and ventilation in major trauma. Background and key messages of the interdisciplinary S3 guidelines for major trauma patients [in German]. Unfallchirurg. 2012 Mar;115(3):251-64. Abstract

Wilson JX, Young GB. Sepsis-associated encephalopathy: evolving concepts. Can J Neurol Sci. 2003 May;30(2):98-105. Abstract

Grubb BP. Clinical practice: neurocardiac syncope. N Engl J Med. 2005 Mar 10;352(10):1004-10. Abstract

Wijdicks EF, Hijdra A, Young GB, et al. Practice parameter: prediction of outcome in comatose survivors after cardiopulmonary resuscitation. Neurology. 2006 Jul 25;67(2):203-10. Abstract

Zwingmann J, Mehlhorn AT, Hammer T, et al. Survival and neurologic outcome after traumatic out-of-hospital cardiopulmonary arrest in a pediatric and adult population: a systematic review. Crit Care. 2012 Jul 6;16(4):R117.Full text  Abstract

Friberg H, Rundgren M, Westhall E, et al. Continuous evaluation of neurological prognosis after cardiac arrest. Acta Anaesthesiol Scand. 2013 Jan;57(1):6-15. Abstract

Kornbluth J, Bhardwaj A. Evaluation of coma: a critical appraisal of popular scoring systems. Neurocrit Care. 2011 Feb;14(1):134-43. Abstract

Wijdicks EF, Bamlet WR, Maramattom BV, et al. Validation of a new coma scale: the FOUR score. Ann Neurol. 2005 Oct;58(4):585-93. Abstract

Towne AR, Waterhouse EJ, Boggs JG, et al. Prevalence of nonconvulsive status epilepticus in comatose patients. Neurology. 2000 Jan 25;54(2):340-5. Abstract

Reference articles

1. Posner JB, Saper CB, Schiff ND, et al. Psychogenic unresponsiveness. Plum and Posner's diagnosis of stupor and coma. New York, NY: Oxford University Press; 2007.

2. Wijdicks EFM. The comatose patient. New York, NY: Oxford University Press; 2007.

3. Young GB, Wijdicks EFM, eds. Disorders of consciousness. Volume 90. The Handbook of Clinical Neurology, 3rd series. New York, NY: Elsevier; 2008.

4. Sporns O. Structure and function of complex brain networks. Dialogues Clin Neurosci. 2013 Sep;15(3):247-62.Full text  Abstract

5. Bodien YG, Carlowicz CA, Chatelle C, et al. Sensitivity and specificity of the coma recovery scale--revised total score in detection of conscious awareness. Arch Phys Med Rehabil. 2016 Mar;97(3):490-492.e1. Abstract

6. Nakagawa TA, Ashwal S, Mathur M, et al. Guidelines for the determination of brain death in infants and children: an update of the 1987 task force recommendations-executive summary. Ann Neurol. 2012 Apr;71(4):573-85. Abstract

7. Vincent SR. The ascending reticular activating system - from aminergic neurons to nitric oxide. J Chem Neuroanat. 2000 Feb;18(1-2):23-30. Abstract

8. Department of Health. Hospital Episode Statistics (England). 2002-2003 [internet publication].Full text

9. Matthes G, Bernhard M, Kanz KG, et al. Emergency anesthesia, airway management and ventilation in major trauma. Background and key messages of the interdisciplinary S3 guidelines for major trauma patients [in German]. Unfallchirurg. 2012 Mar;115(3):251-64. Abstract

10. Bruno MA, Ledoux D, Lambermont B, et al. Comparison of the Full Outline of UnResponsiveness and Glasgow Liege Scale/Glasgow Coma Scale in an intensive care unit population. Neurocrit Care. 2011 Dec;15(3):447-53. Abstract

11. Meschia JF, Bushnell C, Boden-Albala B, et al; American Heart Association Stroke Council; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; Council on Functional Genomics and Translational Biology; Council on Hypertension. Guidelines for the primary prevention of stroke: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014 Dec;45(12):3754-832.Full text  Abstract

12. Lansberg MG, Bluhmki E, Thijs VN. Efficacy and safety of tissue plasminogen activator 3 to 4.5 hours after acute ischemic stroke: a metaanalysis. Stroke. 2009 Jul;40(7):2438-41. Abstract

13. Connolly ES Jr, Rabinstein AA, Carhuapoma JR, et al; American Heart Association Stroke Council; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular Nursing; Council on Cardiovascular Surgery and Anesthesia; Council on Clinical Cardiology. Guidelines for the management of aneurysmal subarachnoid hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2012 Jun;43(6):1711-37.Full text  Abstract

14. Hemphill JC 3rd, Greenberg SM, Anderson CS, et al; American Heart Association Stroke Council; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology. Guidelines for the Management of Spontaneous Intracerebral Hemorrhage: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2015 Jul;46(7):2032-60.Full text  Abstract

15. Steiner T, Al-Shahi Salman R, Beer R, et al; European Stroke Organisation. European Stroke Organisation (ESO) guidelines for the management of spontaneous intracerebral hemorrhage. Int J Stroke. 2014 Oct;9(7):840-55. Abstract

16. Pandor A, Harnan S, Goodacre S, et al. Diagnostic accuracy of clinical characteristics for identifying CT abnormality after minor brain injury: a systematic review and meta-analysis. J Neurotrauma. 2012 Mar 20;29(5):707-18. Abstract

17. Kim YJ. A systematic review of factors contributing to outcomes in patients with traumatic brain injury. J Clin Nurs. 2011 Jun;20(11-12):1518-32. Abstract

18. Oliveira L, Fregni F. Pharmacological and electrical stimulation in chronic disorders of consciousness: new insights and future directions. Brain Inj. 2011;25(4):315-27. Abstract

19. Cowperthwaite MC, Burnett MG. The association between weather and spontaneous subarachnoid hemorrhage: an analysis of 155 US hospitals. Neurosurgery. 2011 Jan;68(1):132-8. Abstract

20. Wilson JX, Young GB. Sepsis-associated encephalopathy: evolving concepts. Can J Neurol Sci. 2003 May;30(2):98-105. Abstract

21. Dalmau J, Gleichman AJ, Hughes EG, et al. Anti-NMDA receptor encephalitis: case series and analysis of the effects of antibodies. Lancet Neurol. 2008 Dec;7(12):1091-8. Abstract

22. Graus F, Saiz A, Lai M, et al. Neuronal surface antigen antibodies in limbic encephalitis: clinical-immunologic associations. Neurology. 2008 Sep 16;71(12):930-6. Abstract

23. Lai M, Hughes EG, Peng X, et al. AMPA receptor antibodies in limbic encephalitis alter synaptic receptor location. Ann Neurol. 2009 Apr;65(4):424-34. Abstract

24. Hjalmarsson A, Blomqvist P, Sköldenberg B. Herpes simplex encephalitis in Sweden, 1990-2001: incidence, morbidity, and mortality. Clin Infect Dis. 2007 Oct 1;45(7):875-80. Abstract

25. Ropper AH, Gorson KC. Clinical practice: concussion. N Eng J Med. 2007 Jan 11;356(2):166-72.Full text  Abstract

26. Shaw NA. The neurophysiology of concussion. Prog Neurobiol. 2002 Jul;67(4):281-344. Abstract

27. Holbourn AH. The mechanics of brain injuries. Br Med Bull. 1945;3:147-9.

28. Povlishock JT, Christman CW. The pathobiology of traumatically induced axonal injury in animals and humans. J Neurotrauma. 1995 Aug;12(4):555-64. Abstract

29. Moulton R. Head Injury. In: Young GB, Ropper AH, Bolton CF, eds. Coma and impaired consciousness: a clinical perspective. New York, NY: McGraw-Hill; 1998:149-181.

30. Young GB, Doig GS. Continuous EEG monitoring in comatose intensive care unit patients: epileptiform activity in etiologically distinct groups. Neurocrit Care. 2005;2(1):5-10. Abstract

31. Calland JF, Ingraham AM, Martin N, et al. Evaluation and management of geriatric trauma: an Eastern Association for the Surgery of Trauma practice management guideline. J Trauma Acute Care Surg. 2012 Nov;73(5 Suppl 4):S345-50. Abstract

32. Grubb BP. Clinical practice: neurocardiac syncope. N Engl J Med. 2005 Mar 10;352(10):1004-10. Abstract

33. Lindboe CF, Loberg EM. Wernicke's encephalopathy in nonalcoholics: an autopsy study. J Neurol Sci. 1989 Apr;90(2):125-9. Abstract

34. Harper CG, Giles M, Finlay-Jones R. Clinical signs in the Wernicke-Korsakoff complex: a retrospective analysis of 131 cases diagnosed at necropsy. J Neurol Neurosurg Psychiatry. 1986 Apr;49(4):341-5. Abstract

35. Canaris GJ, Manowitz NR, Mayor G, et al. The Colorado thyroid disease prevalence study. Arch Intern Med. 2000 Feb 28;160(4):526-34. Abstract

36. Gajdos PH, Korach JM, Conso F, et al. Epidemiological investigation of acute carbon monoxide poisoning (A-CMP) in the Hauts-de-Seine department. Intensive Care Med. 1988;14:434-40.

37. Friedman Y, Lee L, Wherrett JR, et al. Simulation of brain death from fulminant de-efferentation. Can J Neurol Sci. 2003 Nov;30(4):397-404. Abstract

38. Benbadis SR, Agrawal V, Tatum WO. How many patients with psychogenic nonepileptic seizures also have epilepsy? Neurology. 2001 Sep 11;57(5):915-7. Abstract

39. Koguchi K, Nakatsui Y, Abe K, et al. Wernicke's encephalopathy after glucose infusion. Neurology. 2004 Feb 10;62(3):512. Abstract

40. Dunn LT, Fitzpatrick MO, Beard D, et al. Patients with a head injury who "talk and die" in the 1990s. J Trauma. 2003 Mar;54(3):497-502. Abstract

41. Carney N, Totten AM, O'Reilly C, et al. Guidelines for the management of severe traumatic brain injury 4th edition. September 2016 [internet publication].Full text

42. Schmahmann JD. Vascular syndromes of the thalamus. Stroke. 2003 Sep;34(9):2264-78.Full text  Abstract

43. Fujioka M, Okuchi K, Hiramatsu KI, et al. Specific changes in the human brain after hypoglycemic injury. Stroke. 1997 Mar;28(3):584-7.Full text  Abstract

44. Masuhr F, Mehraien S, Einhaupl K. Cerebral venous and sinus thrombosis. J Neurol. 2004 Jan;251(1):11-23. Abstract

45. Roos KL. Infectious etiologies of altered consciousness. Hand Clin Neurol. 2008;90:201-16. Abstract

46. Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016 Feb 23;315(8):801-10.Full text  Abstract

47. Tsuruta R, Oda Y. A clinical perspective of sepsis-associated delirium. J Intensive Care. 2016 Mar 23;4:18.Full text  Abstract

48. Mazeraud A, Pascal Q, Verdonk F, et al. Neuroanatomy and Physiology of Brain Dysfunction in Sepsis. Clin Chest Med. 2016 Jun;37(2):333-45. Abstract

49. Young GB. Encephalopathy of infection and systemic inflammation. J Clin Neurophysiol. 2013 Oct;30(5):454-61. Abstract

50. National Institute for Health and Care Excellence. Sepsis: recognition, diagnosis and early management. September 2017 [internet publication].Full text

51. Royal College of Physicians. National Early Warning Score (NEWS) 2. Dec 2017 [internet publication].Full text

52. American College of Emergency Physicians (ACEP) Expert Panel on Sepsis. DART: an evidence-driven tool to guide the early recognition and treatment of sepsis and septic shock. 2016 [internet publication].Full text

53. Evans L, Rhodes A, Alhazzani W, et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. Crit Care Med. 2021 Nov 1;49(11):e1063-e1143.Full text  Abstract

54. Society of Critical Care Medicine. Surviving Sepsis Campaign Hour-1 bundle. 2019 [internet publication].Full text

55. Vannatta JB, Whang R, Papper S. Efficacy of intravenous phosphorus therapy in the severely hypophosphatemic patient. Arch Intern Med. 1981 Jun;141(7):885-7. Abstract

56. Hinchey J, Chaves C, Appignani B, et al. A reversible posterior leukoencephalopathy syndrome. N Eng J Med. 1996 Feb 22;334(8):494-500.Full text  Abstract

57. Edlow JA, Caplan LR. Avoiding pitfalls in the diagnosis of subarachnoid hemorrhage. N Engl J Med. 2000 Jan 6;342(1):29-36. Abstract

58. Elder PT. Accidental hypothermia. In: Shoemaker W, ed. Textbook of critical care. Philadelphia, PA: WB Saunders; 1989:101-109.

59. Wijdicks EF, Hijdra A, Young GB, et al. Practice parameter: prediction of outcome in comatose survivors after cardiopulmonary resuscitation. Neurology. 2006 Jul 25;67(2):203-10. Abstract

60. Rossetti AO, Oddo M, Logroscino G, et al. Prognostication after cardiac arrest and hypothermia: a prospective study. Ann Neurol. 2010 Mar;67(3):301-7. Abstract

61. Al Thenayan E, Savard M, Sharpe M, et al. Predictors of poor neurologic outcome after induced mild hypothermia following cardiac arrest. Neurology. 2008 Nov 4;71(19):1535-7. Abstract

62. Oddo M, Rossetti AO. Predicting neurological outcome after cardiac arrest. Curr Opin Crit Care. 2011 Jun;17(3):254-9. Abstract

63. Young GB. Clinical practice. Neurologic prognosis after cardiac arrest. N Engl J Med. 2009 Aug 6;361(6):605-11. Abstract

64. Zwingmann J, Mehlhorn AT, Hammer T, et al. Survival and neurologic outcome after traumatic out-of-hospital cardiopulmonary arrest in a pediatric and adult population: a systematic review. Crit Care. 2012 Jul 6;16(4):R117.Full text  Abstract

65. Friberg H, Rundgren M, Westhall E, et al. Continuous evaluation of neurological prognosis after cardiac arrest. Acta Anaesthesiol Scand. 2013 Jan;57(1):6-15. Abstract

66. Geocadin RG, Wijdicks E, Armstrong MJ, et al. Practice guideline summary: reducing brain injury following cardiopulmonary resuscitation: report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology. 2017 May 30;88(22):2141-49.Full text  Abstract

67. Liao KH, Chang CK, Chang HC, et al. Clinical practice guidelines in severe traumatic brain injury in Taiwan. Surg Neurol. 2009 Dec;72 Suppl 2:S66-73. Abstract

68. Brain Trauma Foundation. Guidelines for the field management of combat-related head trauma. Assessment: Glasgow Coma Scale scoring and assessment of pupils [internet publication].Full text

69. Knuth T, Letarte PB, Ling G, et al; Brain Trauma Foundation. Guidelines for the field management of combat-related head trauma. 2005 [internet publication].Full text

70. Lang CJ, Heidenreich SP, Fahlbusch R, et al. Primary loss of consciousness and amnesia in subarachnoid hemorrhage: a quantitative study [in German]. Zentralbl Neurochir. 2004;65(1):18-24. Abstract

71. Kornbluth J, Bhardwaj A. Evaluation of coma: a critical appraisal of popular scoring systems. Neurocrit Care. 2011 Feb;14(1):134-43. Abstract

72. Seel RT, Sherer M, Whyte J, et al; American Congress of Rehabilitation Medicine, Brain Injury-Interdisciplinary Special Interest Group, Disorders of Consciousness Task Force. Assessment scales for disorders of consciousness: evidence-based recommendations for clinical practice and research. Arch Phys Med Rehabil. 2010 Dec;91(12):1795-813. Abstract

73. Zuercher M, Ummenhofer W, Baltussen A, et al. The use of Glasgow Coma Scale in injury assessment: a critical review. Brain Inj. 2009 May;23(5):371-84. Abstract

74. Starmark JE, Holmgren E, Stalhammar D. Current reporting of responsiveness in acute cerebral disorders. J Neurosurg. 1988 Nov;69(5):692-8. Abstract

75. Wijdicks EF, Bamlet WR, Maramattom BV, et al. Validation of a new coma scale: the FOUR score. Ann Neurol. 2005 Oct;58(4):585-93. Abstract

76. Wijdicks EF, Kramer AA, Rohs T Jr, et al. Comparison of the Full Outline of UnResponsiveness score and the Glasgow Coma Scale in predicting mortality in critically ill patients. Crit Care Med. 2015 Feb;43(2):439-44. Abstract

77. Stead LG, Wijdicks EF, Bhagra A, et al. Validation of a new coma scale, the FOUR score, in the emergency department. Neurocrit Care. 2009;10(1):50-4. Abstract

78. Vanhaudenhuyse A, Schnakers C, Boly M, et al. Behavioural assessment and functional neuro-imaging in vegetative state patients. Rev Med Liege. 2007;62 Spec No:15-20. Abstract

79. Morrow SA, Young GB. Selective abolition of the vestibular-ocular reflex by sedative drugs. Neurocrit Care. 2007;6(1):45-8. Abstract

80. Kraft MD, Btaiche IF, Sacks GS. Review of the refeeding syndrome. Nutr Clin Pract. 2005 Dec;20(6):625-33. Abstract

81. Young GB, Jordan KG, Doig GS. An assessment of nonconvulsive seizures in the intensive care unit using continuous EEG monitoring: an investigation of variables associated with mortality. Neurology. 1996 Jul;47(1):83-99. Abstract

82. National Institute for Health and Care Excellence. Head injury: assessment and early management. September 2019 [internet publication].Full text

83. Delorenzo RJ, Waterhouse EJ, Towne AR, et al. Persistent non-convulsive status epilepticus following the control of convulsive status epilepticus. Epilepsia. 1998 Aug;39(8):833-40. Abstract

84. Towne AR, Waterhouse EJ, Boggs JG, et al. Prevalence of nonconvulsive status epilepticus in comatose patients. Neurology. 2000 Jan 25;54(2):340-5. Abstract

85. Lescot T, Galanaud D, Puybasset L. Exploring altered consciousness states by magnetic resonance imaging in brain injury. Ann N Y Acad Sci. 2009 Mar;1157:71-80. Abstract

86. Wu HM, Huang SC, Hattori N, et al. Selective metabolic reduction in gray matter acutely following human traumatic brain injury. Neurotrauma. 2004 Feb;21(2):149-61. Abstract

87. Lee YC, Phan TG, Jolley DJ, et al. Accuracy of clinical signs, SEP, and EEG in predicting outcome of hypoxic coma: a meta-analysis. Neurology. 2010 Feb 16;74(7):572-8. Abstract

88. Carrai R, Grippo A, Lori S, et al. Prognostic value of somatosensory evoked potentials in comatose children: a systematic literature review. Intensive Care Med. 2010 Jul;36(7):1112-26. Abstract

89. Xu J, Rasmussen IA, Lagopoulos J, et al. Diffuse axonal injury in severe traumatic brain injury visualized using high-resolution diffusion tensor imaging. J Neurotrauma. 2007 May;24(5):753-65. Abstract

90. Goldstein LB, Adams R, Alberts MJ, et al; American Heart Association; American Stroke Association Stroke Council. Primary prevention of ischemic stroke: a guideline from the American Heart Association/American Stroke Association Stroke Council: cosponsored by the Atherosclerotic Peripheral Vascular Disease Interdisciplinary Working Group; Cardiovascular Nursing Council; Clinical Cardiology Council; Nutrition, Physical Activity, and Metabolism Council; and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Circulation. 2006 Jun 20;113(24):e873-923.Full text  Abstract

91. Ashwal S, Babikian T, Gardner-Nicols J, et al. Susceptibility-weighted imaging and proton magnetic resonance spectroscopy in assessment of outcome after pediatric traumatic brain injury. Arch Phys Med Rehabil. 2006 Dec;87(12 Suppl 2):S50-8. Abstract

92. Burch HB, Wartofsky L. Life-threatening thyrotoxicosis: thyroid storm. Endocrinol Metab Clin North Am. 1993 Jun;22(2):263-77. Abstract

Use of this content is subject to our disclaimer