Outcome Prediction by Recovering Signs in Acute Head Injury

Abstract

Correlation between outcome and various initial recovering signs was investigated in 40 head injury patients whose Glasgow Coma Scale (GCS) on admission were 11 and/or less. Recovering signs, including spontaneous limb movement (SLM), open eyes (CIE), obey commands (OC), and pursuit eye movement (PEM) were chronologically followed. Light reflex seemed to be the best predicting factor among the other initial factors. The patients with admission GCS of 6-8 showed various outcomes and patterns in recoveries of signs. The predicting power of the recovering signs, such as OC and PEM, gradually became stronger after head injury. These signs were stronger than any initial factors following the 6th day after head injury. The predicting powers of simple signs, such as OE and SLM, were more powerful than those of complicated signs, such as OC and PEM, immediately after head injury. However, the predicting power of complicated signs became stronger than that of simple signs after 3-6 days following head injury. Continuous follow-up of the recovering signs should be important in predicting outcome, because each predicting factor changes its predicting power, depending on elapsed time following head injury.