|
Overview :
The Pittsburgh Brain Stem Score (PBSS) can be used to assess
brain stem reflexes in a comatose patient.
|
Brain Stem
Reflex |
Finding |
Points |
|
lash reflex |
present either side |
2 |
|
|
absent both sides |
1 |
|
corneal reflex |
present either side |
2 |
|
|
absent both sides |
1 |
|
doll's eye and/or ice water calorics |
present either side |
2 |
|
|
absent both sides |
1 |
|
right pupil reaction to light |
present |
2 |
|
|
absent |
1 |
|
left pupil reaction to light |
present |
2 |
|
|
absent |
1 |
|
gag and/or cough reflex |
present |
2 |
|
|
absent |
1 |
(see Table 3 Schuster and Dick, page 33; Table 3 BRCT II,
page 530)
Pittsburgh brain stem score =
= SUM(points for reflexes)
Interpretation:
• minimum
score: 6
• maximum
score: 12
• The
higher the score, the better.
• The PBSS
may be added to the Glasgow Coma score to give a combined Glasgow-Pittsburgh
Coma Score. With the above configuration to the PBSS, the combined score would
have a range of 9 - 27.
Variations:
• In the
Brain Resuscitation Clinical Trial, the lash and corneal reflex appear to
represent a single scored parameter.
• In Edgren
et al a modified Pittsburgh score (undefined) is reported to have a best score
of 20 and a worst score of 4.
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