Anoxic brain injury physical examination: Difference between revisions
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Revision as of 14:33, 23 January 2013
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Physical Examination
Serial neurologic examinations are critical in the assessment of long term prognosis.
Neurological Examination
Brainstem Assessment
The brainstem is more resistant to hypoperfusion that the cerebral cortex, and if the brainstem does not recover, the cerebral cortex is not likely to recover. The presence of brain stem reflexes is therefore critical to recovery. Preservation of brainstem function is indicated by the presence of blinking, coughing, gagging, sneezing, and yawning.
Pupillary Size
The presence of peristently dilated pupils is a poor prognostic sign [1]. It should be noted that both catecholamines and atropine, can affect pupillary size, and confound the assessment of pupillary size.
References
- ↑ Steen-Hansen JE, Hansen NN, Vaagenes P, Schreiner B: Pupil size and light reactivity during cardiopulmonary resuscitation. A clinical study. Crit Care Med 1988;16:69-70.