Evaluating the comatose patient: Rapid neurologic assessment is key to appropriate management

Khalid Malik, David C Hess

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Coma is defined as a sleeplike state in which the patient is unresponsive to self and the environment. Coma should be distinguished from the persistent vegetative state and locked-in syndrome. It is important to obtain a carefully taken history from eyewitnesses and to perform a rapid neurologic examination focusing on pupillary responses, eye movements, and motor responses. Pupils reactive to light usually indicate metabolic or medical coma; cerebellar infarction or hemorrhage is a notable exception. A pupil unreactive to light often points to a structural brain lesion and the need for urgent neurosurgical consultation. The prognosis for coma depends on the cause.

Original languageEnglish (US)
Pages (from-to)38-55
Number of pages18
JournalPostgraduate medicine
Volume111
Issue number2
DOIs
StatePublished - Jan 1 2002

Fingerprint

Coma
Nervous System
Pupil
Persistent Vegetative State
Light
Quadriplegia
Neurologic Examination
Eye Movements
Infarction
Referral and Consultation
History
Hemorrhage
Brain

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Evaluating the comatose patient : Rapid neurologic assessment is key to appropriate management. / Malik, Khalid; Hess, David C.

In: Postgraduate medicine, Vol. 111, No. 2, 01.01.2002, p. 38-55.

Research output: Contribution to journalArticle

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