PROGNOSTICATION!AFTER!NEURO!DISASTERS

ICH

size

image by Geigy

ageimage by Bev Sykes

GCSphoto by og2t // ou gee tew tee

LOCATION LOCATION LOCATION

photo by Michael Matti

ABOVE OR BELOW THE TENT

DEMENTIA

photo byKurt Komoda

func

84M!GCS 7!

80 ml ICH!Basal ganglia bleed!

Some IVH!Mild cognitive impairment

72F!GCS 10!

20 ml ICH!Lobar bleed!

No IVH!No cognitive impairment

TBI

GCS

GCS SHOCK

GCS >60SHOCK

GCS >60SHOCK

GCS >60SHOCK

GCS >60SHOCK

Australia!37M!

GCS 3!Pupils reacting!

No hypoxia or hypotension!Isolated TBI!

CT with petichial haemorhages, mass effect 3rd ventricle

compressed, no SAH, no MLS!BGL 7.0 Hb 8.8

aSAH

photo by liquidnight

35%

DISABILITY CAN BE HARD TO MEASURE

photo by Keoni Cabral

GRADE!AGE BLOOD

GCSphoto by og2t // ou gee tew tee

HH1 Asymptomatic, mild headache, slight nuchal rigidity

2 Moderate to severe headache, nuchal rigidity, no neurologic deficit other than cranial nerve palsy

3 Drowsiness / confusion, mild focal neurologic deficit

4 Stupor, moderate-severe hemiparesis

5 Coma, decerebrate posturing

Grade GCS Motor deficit

I 15 -

II 13-14 -

III 13-14 +

IV 7-12 -/+

V 3-6 -/+

CARTER

photo by Leo Reynolds

photo by Leo Reynolds

So this means.....?

SEIZUREHCP

SEIZURE DRUGS

THE!HISTORY

THE!ANEURYSM

AED

HYPERGLYCAEMIA

ANAEMIA

LOW VOL CENTRES

ICU COMPLICATIONS

STROKE

42 616

LEVEL!OF!CONSCIOUSNESS

EYE MOVEMENT

HORIZONTAL

VISUAL!FIELDS

FACIAL!PALSY

MOTOR:!ARMS

MOTOR:!LEGS

LIMB!ATAXIA

SENSORY

LANGUAGE & SPEECH

Inattention

The patient and family understand the potential risks and benefits of therapy

SPAN-100

ICH SCORE FUNC!TBI IMPACT CRASH!SAH WFNS!

CVA NIHSS

BE!AN!INFORMED!AGNOSTIC.