[An assessment of outcome prediction in patients with severe brain damage with auditory brainstem response and blink reflex].
Results of auditory brainstem response (ABR) and electrically elicited blink reflex (BR) recorded from 43 patients with severe brain damage within three days after the onset of illness were analyzed to assess the prognostic value of ABR and BR with respect to patient outcome evaluated by the criteria proposed by Jennett and Bond. It was possible to recognize, in recordings obtained from patients with severe brain damage, three basic patterns of BR as well as five patterns of ABR within three days after the onset. Three basic patterns of BR were composed of Type I, which closely approximated the BR of normal subjects except for moderately prolonged latency of R2, Type II, which indicated absence of bilateral R2 activities, and Type III, which showed absence of R1 as well as bilateral R2. ABRs were graded, in increasing order of abnormality, from Type I to Type V. Type I was almost normal pattern from wave I to wave V. Type II indicated prolonged latency or markedly reduced amplitude of waves IV and V. Type III showed absence of waves IV and V. Type IV had only wave I. Type V indicated absence of all waves. BR abnormalities significantly proved useful in predicting vital prognosis of the comatose patients with supratentorial lesion. In patients who had Type II of BR, additional studies of ABR enhanced the reliability of prediction of functional prognosis. On the other hand, ABR was recognized as stronger basis for predicting outcome in patients with infratentorial lesion. All patients with Type IV or Type V of ABR were expired within one month after the onset.(ABSTRACT TRUNCATED AT 250 WORDS)