Sensory evoked responses in head injury.

ABSTRACT Head trauma is a significant source of morbidity in the United States each year. Approximately 700 patients were admitted to our surgical intensive care unit with some degree of head trauma in a 24-month period. Glasgow Coma Score (GCS) was 8 or less in 90% of this group, and 3 or 4 in 43%. Sensory evoked responses were recorded in over 500 patients. This study is reported to demonstrate that optimum care of the injured brain depends on titration of care aimed at maintaining normal neuronal function. In our series, 25% of the patients with GCS of 3 or 4 returned home or to a rehabilitation unit, a significant decrease in morbidity over other reported series. Chemical paralysis and barbiturate coma were a factor in the decision to monitor in 50–60% of the series. In these patients, the auditory brainstem evoked response (ABR), a monitor of brainstem neuroelectrical function, and the somatosensory evoked response, a monitor of brainstem and cortical function, were used to follow the effectiveness o...