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50 Years of the Glasgow Coma Scale: A historical perspective.
J Clin Neurosci
January 2025
Faculty of Health and Medical Sciences, The University of Adelaide, Australia.
The Glasgow Coma Scale (GCS) was first published in The Lancet by Sir Graham Teasdale and Bryan Jennett 50 years ago based on their pioneering work on developing a numerical scale to describe coma in clear and reproducible terms and to avoid the confusion associated with the wide variety of descriptive terms for consciousness that were in use at the time. It's difficult to know if Teasdale and Jennett could have predicted how influential, widespread and long-lasting the GCS would become, but in retrospect it seems clear that the GCS was introduced at a perfect stage in the development of modern clinical neurosurgery and neuroscience research. The simplicity of the scale, its recognition by senior academics and the emerging radiology technologies in the 1970s heralded a new era of neuroscience and an approach to the management of not only traumatic brain injury (TBI) but other types of central nervous system disease in which consciousness was affected, such as aneurysmal subarachnoid haemorrhage and stroke.
View Article and Find Full Text PDFContinuous quantitative electroencephalography for early detection of acute low-pressure obstructive hydrocephalus in aneurysmal subarachnoid hemorrhage: illustrative case.
J Neurosurg Case Lessons
December 2024
Department of Medicine, Neuroscience Intensive Care Unit, Medical Critical Care Service, INOVA Fairfax Hospital, Falls Church, Virginia.
Background: Aneurysmal subarachnoid hemorrhage (aSAH) is often associated with acute high-pressure hydrocephalus. Less commonly, an acute low-pressure hydrocephalus (ALPH) variant can develop and contribute to increased morbidity. ALPH is particularly challenging to diagnose and manage, as patients present with symptoms of increased intracranial pressure (ICP) despite the absence of corroborating evidence from ICP measurements.
View Article and Find Full Text PDFIntracranial Rupture of an Intradiploic Dermoid Cyst Resembling an Erupting Volcano: A Case Report.
J Korean Soc Radiol
November 2024
Department of Trauma & Emergency, All India Institute of Medical Sciences (AIIMS), Bhopal, India.
Dermoid cysts originate from embryonic tissues trapped in the cranial fusion lines and typically manifest extra-axially. However, intradiploic dermoid cysts are rare among cranial tumors, and their rupture has been sparsely documented. We present a case showcasing a remarkable phenomenon-the spontaneous rupture of an intradiploic dermoid cyst into the subarachnoid space, displaying a distinct "volcano-like" appearance on CT and MRI scans.
View Article and Find Full Text PDFA rare case of posttraumatic subdural hematoma and intratumoral hemorrhage in a left frontotemporal meningioma: a conservative approach with longitudinal follow-up. Illustrative case.
J Neurosurg Case Lessons
November 2024
Department of Neurosurgery, Abdali Hospital, Amman, Jordan.
Article Synopsis
- * A case study of a 78-year-old man showed that, despite having a subdurmal hematoma and bleeding within a meningioma, he improved significantly with conservative management rather than immediate surgery.
- * The findings emphasize that treatment should be tailored to individual cases, showing that conservative approaches can be effective for some patients with stable hemorrhagic meningiomas.
Reversible Cerebral Vasoconstriction Syndrome for the Internist-A Narrative Review.
Am J Med
November 2024
Department of Neurology, Massachusetts General Hospital, Boston, Mass.
Reversible cerebral vasoconstriction syndrome is a common, increasingly recognized cause of thunderclap headache. Most patients have some type of trigger that precedes the onset (e.g.
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