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J Neurol Neurosurg Psychiatry 74:1157-1158 doi:10.1136/jnnp.74.8.1157-a
  • Letter

Favourable outcome of a brain trauma patient despite bilateral loss of cortical somatosensory evoked potential during thiopental sedation

  1. P A Robe1,
  2. A Dubuisson1,
  3. S Bartsch2,
  4. P Damas2,
  5. S Laureys3
  1. 1Service of Neurosurgery, University Hospital of Liége, Liége, Belgium
  2. 2Service of Critical Care Medicine, University Hospital of Liége
  3. 3Service of Neurology, University Hospital of Liége
  1. Correspondence to:
 Dr P A Robe, Department of Neurosurgery, CHU de Liége, Domaine universitaire du Sart Tilman, B35, 4000 Liége, Belgium;
 pierre.robe{at}ulg.ac.be

    We would like to present an observation that somewhat questions the predictive value of somatosensory evoked potentials on the outcome of brain trauma patients treated with thiopental coma.1,2

    A 30 year old woman suffered a high velocity car accident resulting in a diffuse brain injury. Her Glasgow coma scale score on admission was E2V2M5 (9/15), with preserved pupillary reflexes and gross motor function. Computed tomography of the head showed a traumatic disjunction of the lambdoid suture and multiple left frontobasal and temporal cerebral contusions. The patient was sedated with propofol, intubated, and monitored for intracerebral pressure (ICP) through an external ventricular drain. Her clinical condition rapidly worsened because of brain swelling around the contusions, and cerebrospinal fluid drainage, manitol boluses, and mild hyperventilation were …