Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Coma”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 631 records · Page 35Linked to original sources
PubMed1990

[Early somatosensory and auditory evoked potentials in anoxic coma. Role in evaluating and prognostic value].

Early somatosensory (ESEP) and auditory (EAEP) evoked potentials were recorded in 27 patients with severe coma (Glasgow score less than 5) following cardiorespiratory arrest, within the first 7 days of its course. Somatosensory responses were elicited by stimulation of the median nerve. ESEP were abolished in 17 patients due to a parietal thalamo-cortical lesion. Among these, 6 patients died within one month and 11 presented with a persistent vegetative state. In all patients EAEP were obtained, showing functional brainstem activity. Low-voltage EAEP, especially for peak V (inferior colliculus or upper part of the brainstem), was sometimes observed. One patient, in whom ESEP and EAEP were initially abolished, died rapidly. In 9 other patients scalp-recorded ESEP and EAEP were normal; all emerged from coma including 5 with good neurological recovery and 4 with neurological sequelae. Clinical, electroencephalographic and computerized tomographic data appeared to be devoid of predictive value at the same initial period. In view of their sensitivity to anoxia and to cerebral oedema, even with neurosedative drugs, ESEP seemed to be reliable in predicting outcomes and in evaluating central nervous system lesions at cortical and subcortical levels (basal ganglia and brainstem) after cardiorespiratory arrest.

Adolescent↗
PubMed1977

[Electroencephalographic study of functional metabolic encephalopathies and comas during parenteral alimentation].

This review deals with the common E.E.G. characteristics of dysmetabolic encephalopathies and described the particular features of hepatic, respiratory and renal encephalopathies, as well as those resulting from a disturbance in carbohydrate, water and electrolyte metabolism. These now classical data are compared with the principal electroclinical appearances seen during parenteral alimentation : slow, ample wases, non-reactive, associated with a calm coma; overall depression of basal rhythm, with excessive myogram activity and corresponding to paroxysms of muscular hypertonia seen during the coma.

Chronic Disease↗
PubMed1983

[Hyperosmolar diabetic coma. Case reports and review of the literature].

The physiopathology and clinical picture of hyperosmolar diabetic coma are described, and four personal cases are presented. This form of coma is a rare, but particularly serious complication of diabetes mellitus. Since its prognosis is poor, even when suitable treatment is provided, the greatest possible care should be devoted to preventing its main cause, namely dehydration.

Aged↗
PubMed1980

[Hyperosmolar non-ketotic diabetic coma in children (author's transl)].

A 12 year old female patient presenting non ketotic hyperosmolar hyperglycemic coma as initial sign of diabetes mellitus is presented. She was successfully treated with continuous infusion of low dose of insulin and saline and glycosaline isotonic sera. Potassium was precociously added to the hydrating solutions. During convalescence she suffered a left iliofemoral thrombophlebitis which remitted with appropriate treatment. In coma stage, C-peptide was close to normal, indicating active insulin production by the pancreas.

Child↗
PubMed1980

[Physiopathology of non-ketotic hyperosmolar coma in diabetes (author's transl)].

Hyperosmolar diabetic coma is characterised by extreme hyperglycaemia and dehydration. Hypernatremia often contributes additionally to plasma hyperosmolarity. The pathogenesis of these component abnormalities is considered. The explanation of the absence of hyperketonaemia is examined in the light of recent experimental and clinical data. At the beginning of the development of the syndrome, high peripheral plasma insulin probably explains the lack of ketosis via inhibition of lipolysis. Later, when hyperosmolar coma is established, peripheral insulinopenia but an "insulinised" liver may coexist. This would favour metabolism of free fatty acids along nonketogenic pathways.

Blood↗
PubMed1982

[Transitory ECG changes of an ischemic type during hyperosmolar non-ketoacidotic coma].

Hyperosmolar coma was the presenting feature of type I diabetes in a 20 year old man. Ischemic ECG abnormalities (downsloping ST depression of 5 mm in the anterior leads) were present during the comatose state but not in the following days, when a satisfactory metabolic control was achieved. Coronary heart disease was excluded on the basis of the normal response to a treadmill test carried out 6 months later. Hyperglycemia, hypokalemia, shock, hyperventilation and perhaps hyperosmolarity are responsible for these ECG changes. Caution must be used before considering such ECG patterns as ischemic in patients with this type of coma.

Adult↗
PubMed1978

[Hyperosmolar nonketotic diabetic coma. Treatment with continuous low-dose insulin infusion (author's transl)].

We report the case of a boy aged 9 1/2 years with hyperosmolar, nonketotic diabetic coma. He was not known to be diabetic prior to the onset of coma. Pathogenetic aspects of this rare manifestation of juvenile diabetes are discussed. It is dangerous to decrease osmolarity too rapidly during infusion of very hypotonic solutions. Treatment with continuous low-dose insulin infusion may cautiously be tried.

Child↗
PubMed1995

Early restructuration of consciousness after traumatic coma.

Recovery of consciousness after acute brain injury is a remarkable phenomenon, yet, not completely understood. We describe the early clinical stages of recovery of consciousness in 48 selected patients by means of different items of the Glasgow Coma and Liege Coma Scales. Arousal, expressed by the stimulated opening of the eyes (E2) was correlated with the appearance of the localizing pain response (M5), with the capacity to obey commands (M6), with the opening of the eyes (E4) and with the blink reflex (R5). This study confirms the classical clinical sequence of arousal and recovery of consciousness characterized by the consecutive appearance of E2, R5, E4, M5 and M6. When the appearance of E2 and R5 are considered separately, we noticed a significant difference, suggesting different structural and functional brain recovery processes.

Adolescent↗
PubMed1976

[Hyperosmolar Coma].

For some little time it has been known that hyperosmolar coma is a clinical condition which may arise from various causes and yet is based on a fundamental pathophysiological disturbance: extracellular hyperosmolarity, usually accompanied by hyperglycemia or hypernatremia. The clinical and biological picture is easily recognizable and requires immediate and massive rehydration with hypotonic solutions. Many pathological uncertainties still exist, but one thing is certain and of great importance: in many cases, hyperosmolar coma is the result of errors or negligence: for this reason it is essential know this syndrome so that it may be better avoided.

Adult↗
PubMed1975

Alpha-coma. Electroencephalographic, clinical, pathologic, and etiologic correlations.

"Alpha-coma" denotes the conjunction of clinical coma with an electroencephalographic pattern resembling that of normal wakefulness and predominantly consisting of alpha activity. Clinical, EEG, and pathologic data from 13 patients with this syndrome were reviewed. The patients were divided into two groups, based on the pathogenesis of their conditions. The first group consisted of eight patients with brain stem strokes, and the second group consisted of five patients with diffuse hypoxic encephalopathy resulting from cardiac or pulmonary arrest. There were some differences between the EEGs of the two groups. In the first group, the alpha pattern was located more posteriorly, showed more variability and reactivity, and was more persistent in sequential recordings. In the second group, the alpha activity was transient and showed little reactivity. In both groups, this pattern indicated a poor prognosis for survival.

Aged↗
PubMed1985

Early cortical median nerve somatosensory evoked potentials. Prognostic value in anoxic coma.

Subcortical and early cortical median nerve somatosensory evoked potentials (SEPs) were examined in 26 patients in hypoxic coma. The amplitude ratio between the negative slope of the scalp response and the following positive trough was determined. The latency difference between the major negative component recorded from the upper neck, N14, and the initial negative potential from the scalp, N20, was also measured. The mean of these parameters in both hemispheres was referred to as mean central conduction time (MCCT) and mean amplitude ratio (MAR). There was a significant difference in MAR in patients with a bilaterally recordable scalp response between those with a good and those with a bad outcome, but no difference in MCCT. Comparison of SEP findings with postmortem examinations suggests that a reduced MAR may yield an estimate of cortical damage in hypoxic coma.

Adult↗
PubMed1991

Vegetative state after closed-head injury. A Traumatic Coma Data Bank Report.

To elucidate the clinical course of the vegetative state after severe closed-head injury, the Traumatic Coma Data Bank was analyzed for outcome at the time of discharge from the hospital and after follow-up intervals ranging up to 3 years after injury. Of 650 patients with closed-head injury available for analysis, 93 (14%) were discharged in a vegetative state. In comparison with conscious survivors, patients in a vegetative state sustained more severe closed-head injury as reflected by the Glasgow Coma Scale scores and pupillary findings and more frequently had diffuse injury complicated by swelling or shift in midline structures. Of 84 patients in a vegetative state who provided follow-up data, 41% became conscious by 6 months, 52% regained consciousness by 1 year, and 58% recovered consciousness within the 3-year follow-up interval. A logistic regression failed to identify predictors of recovery from the vegetative state.

Adolescent↗
PubMed1984

A preliminary prospective neurophysiological study of coma in children.

Electroencephalograms, brain-stem auditory evoked potentials (BAEPs), visual evoked potentials to diffuse flash (FVEPs), and neurological examinations were performed on 17 comatose children within the first 24 hours of the onset of coma and serially thereafter; the results were correlated with clinical outcome. Children with initially unrecordable FVEPs had poor outcomes; of ten children, five died and five survived with severe neurological deficits. Initially recordable FVEPs in seven children were associated with survival; six of the seven had mild to no neurological residua. Impaired brain-stem function, determined on initial neurological examination, was associated with survival in children with normal BAEPs. All patients with intact brain-stem function survived, but the best outcome was seen in those with recordable FVEPs. Studies of FVEPs and BAEPs are useful in the assessment of coma in children and provide prognostic information concerning the consequences of the underlying insult.

Adolescent↗
PubMed1981

Thrombotic thrombocytopenic purpura: prolonged coma with recovery of neurologic function with intensive plasma exchange.

A 45-year-old-woman was presented with fever, microangiopathic hemolytic anemia, thrombocytopenia, purpura, and mental status changes. She was diagnosed as having thrombotic thrombocytopenic purpura (TPP). She was treated with daily plasma exchange and antiplatelet drugs, steroids, and vincristine. This patient had a remarkable course with 18 days of coma on full therapy followed by essentially complete recovery coincident with an increase of the plasma exchange dose to two plasma volumes processed per procedure. The patient has remained well with discontinuation of plasma exchange. We conclude that prolonged coma without evidence of major central nervous system structural lesions in TTP should be treated vigorously and continuously with plasma exchange.

Aspirin↗
PubMed1977

Alpha-pattern coma: 24 cases with 9 survivors.

Alpha-pattern coma denotes the association of a comatose state with an electroencephalogram consisting predominately of alpha-frequency activity. Over the past three years we have studied 24 such cases: 14 following cardiopulmonary arrest, 6 following respiratory arrest, and 3 following brainstem infarction. Of the 9 patients who survived, only 1 had a significant neurological deficit. It was found that: (1) alpha-pattern coma can result from a variety of neurological insults; (2) a significant proportion of patients survive, often with little or no deficit; (3) clinical evidence of intact brainstem function implies a favorable outcome; (4) the electroencephalogram was similar in survivors and nonsurvivors and did not differentiate diffuse cerebral dysfunction from focal brainstem disease; and (5) neuropathological studies demonstrated diffuse cortical as well as brainstem changes.

Adult↗
PubMed1977

A prospective study of nontraumatic coma: methods and results in 310 patients.

Neurological signs and outcome are compared in the first 310 patients from a continuing prospective study of coma not caused by trauma or drugs. Sixteen percent of the patients achieved an independent existence within a month; severe disability or the vegetative state developed in 25% of patients comatose for six hours and in 79% of those still in coma after a week. The chance of regaining an independent existence was greater in patients who, by one day, obeyed commands or moved the limbs appropriately in response to noxious stimuli or who had attained any of the following: orienting eye movements, normal responses to oculocephalic or oculovestibular stimulation, or normal muscle tone. Conversely, the chance of regaining an independent existence fell in patients who, after one day, had either extensor responses of the limbs or failed to move them in response to noxious stimuli or who lacked eye opening, pupillary reactions, corneal responses, or any eye movement in response to oculovestibular or oculocephalic stimulation. Beyond these general guidelines, numbers of patients with particular signs are presently too small for confident prediction of outcome.

Adolescent↗
PubMed1981

Alpha-pattern coma in a 2-month-old child.

A 2-month-old infant is described in whom the electroencephalographic finding of alpha-frequency activity was correlated with a clinical state of unresponsiveness. This condition occurred following a period of hypoxia and was similar to alpha-patter coma in adults. The finding of alpha-pattern coma in a young infant suggests that alpha-frequency activity in comatose states in abnormally generated since alpha-frequency activity normally is not found in this age group.

Alpha Rhythm↗
PubMed1979

Factors influencing the outcome of coma in severely injured patients.

From this analysis we may conclude that the most important factors influencing the outcome of coma due to injury are age, vegetative state, level of coma, decerebration, and hypocapnia. In all cases where a combination of four or more of any of the above-mentioned factors was present the patient died. EEG seems less predictive in the early period, but may give some information for late prognosis.

Adolescent↗