Clinical, Radiologic, and Legal Significance of "Extensor Response" in XXXX .

@entity1 @entity1164 @entity131 @entity75 @entity16 @entity542 @entity772
UNASSIGNED: Objective   The timely detection of @entity16 can be critical for the survival of a neurosurgical @entity1 following @entity542 . Because little reliable evidence is available on the prognostic value of the clinical sign "extensor response" in @entity772 posttraumatic @entity1 , we investigated the correlation of this clinical sign with outcome and with early radiologic findings from magnetic resonance imaging (MRI). Methods   This retrospective analysis of prospectively obtained data included 157 @entity1 who had remained in a @entity772 for a minimum of 24 hours after @entity131 . All @entity1 received a 1.5-T MRI within 10 days (median: 2 days) of the injury. The correlations between clinical findings 12 and 24 hours after the injury-in particular, extensor response and pupillary function, MRI findings, and outcome after 1 year-were investigated. Statistical analysis included contingency tables, Fisher exact test, odds ratios (ORs) with confidence intervals (CIs), and weighted k values. Results   There were 48 @entity1 with extensor response within the first 24 hours after the injury. @entity1 with extensor response (World Federation of Neurosurgical Societies @entity772 grade III) statistically were significantly more likely to @entity75 in the brainstem when compared with @entity1 in a @entity772 who had no further deficiencies ( @entity772 grade I; p   =   0.0004 by Fisher exact test, OR 10.8 with 95% CI, 2.7-42.5) and @entity1 with unilateral loss of pupil function ( @entity772 grade II; p   =   0.0187, OR 2.8 with 95% CI, 1.2-6.5). The correlation of @entity75 as found by MRI and outcome according to the Glasgow Outcome Scale after 1   year was also highly significant (p    <=   0.016). Conclusion   The correlation of extensor response and loss of pupil function with an unfavorable outcome and with @entity75 revealed by MRI is highly significant. Their sudden onset may be associated with the @entity1164 and should therefore be regarded as one of the most fundamental warning signs in the clinical monitoring of @entity772 @entity1 .
