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April 1984

Multimodality Evoked Potentials in Closed Head Trauma

Author Affiliations

From the Departments of Neurology (Drs Anderson and Bundlie) and Neurosurgery (Dr Rockswold), Hennepin County Medical Center, and the University of Minnesota Medical School (Drs Anderson, Bundlie, and Rockswold), Minneapolis.

Arch Neurol. 1984;41(4):369-374. doi:10.1001/archneur.1984.04050160031011

• Patients with closed head injuries who had Glasgow coma scale scores of 7 or less were studied with evoked potentials soon after trauma. Of the patients, 39 had brain-stem auditory evoked potentials (BAEPs); 12, stroboscopic visual evoked potentials (VEPs); and 23, short-latency somatosensory evoked potentials (SSEPs). Evoked potential results were graded from 1 (normal) to 4 (most abnormal). Outcomes were categorized by the Glasgow outcome scale, with good out-come and moderate disability further classified as "favorable" and severe disability, vegetative state, and death as "unfavorable." The BAEPs and VEPs were reliable predictors of an unfavorable but not a favorable outcome. The SSEPs reliably predicted both kinds of outcomes. No instances of "false pessimism" were encountered in any modality. Evoked potential results were more reliable than intracranial pressure, pupillary light reaction, or motor findings in predicting out-come. Frequent occurrence of peripheral auditory injuries was shown.

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