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Objective: To determine the validity and reliability of the Korean version of the Coma Recovery Scale-Revised (K-CRSR) for evaluation of patients with a severe brain lesion.
Methods: With permission from Giacino, the developer of the Coma Recovery Scale Revised (CRSR), the scale was translated into Korean and back-translated into English by a Korean physiatrist highly proficient in English, and then verified by the original developer. Adult patients with a severe brain lesion following traumatic brain injury, stroke, or hypoxic brain injury were examined. To assess the inter-rater reliability, all patients were tested with K-CRSR by two physiatrists individually. To determine intra-rater reliability, the same test was re-administered by the same physiatrists after three days.
Results: Inter-rater reliability (k=0.929, p<0.01) and intra-rater reliability (k=0.938, p<0.01) were both high for total K-CRSR scores. Inter- and intra-rater agreement rates were very high (94.9% and 97.4%, respectively). The total K-CRSR score was significantly correlated with K-GCS (r=0.894, p<0.01), demonstrating sufficient concurrent validity.
Conclusion: K-CRSR is a reliable and valid instrument for the assessment of patients with brain injury by trained physiatrists. This scale is useful in differentiating patients in minimally conscious state from those in vegetative state.
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http://dx.doi.org/10.5535/arm.2018.42.4.536 | DOI Listing |
J Neurosurg Pediatr
September 2025
1Department of Neurosurgery, University of Utah, Salt Lake City.
Objective: The concept of spinal cord injury without radiographic abnormality (SCIWORA) was introduced in the 1980s. Unfortunately, the nomenclature creates confusion in the modern MRI-based era when applied to pediatric traumatic spinal injuries. The authors investigated the incidence and clinical characteristics of pediatric patients with true imaging-negative traumatic cervical spinal cord injuries (SCIs).
View Article and Find Full Text PDFCrit Care Explor
September 2025
Surgical Services, Minneapolis VA Medical Center, Minneapolis, MN.
Objective: This post hoc study of the Progesterone for Traumatic Brain Injury, Experimental Clinical Treatment (ProTECT) III trial investigates whether improving traumatic brain injury (TBI) classification, using serum biomarkers (glial fibrillary acidic protein [GFAP] and ubiquitin carboxyl-terminal esterase L1 [UCH-L1]) and algorithmically assessed total lesion volume, could identify a subset of responders to progesterone treatment, beyond broad measures like the Glasgow Coma Scale (GCS) and Glasgow Outcome Scale-Extended (GOS-E), which may fail to capture subtle changes in TBI recovery.
Design: Brain lesion volumes on CT scans were quantified using Brain Lesion Analysis and Segmentation Tool for CT. Patients were classified into true-positive and true-negative groups based on an optimization scheme to determine a threshold that maximizes agreement between radiological assessment and objectively measured lesion volume.
CNS Neurosci Ther
September 2025
Department of Rehabilitation Medicine, Xuan Wu Hospital, Capital Medical University, Beijing, China.
Objective: To verify the effectiveness of the parietal repetitive transcranial magnetic stimulation (rTMS) and take advantage of TMS-EEG to assess cortical excitability in patients with minimally conscious states (MCS).
Methods: We enrolled 10 MCS patients who received 10 sessions of 10 Hz rTMS on the parietal cortex for 10 consecutive days and then 10 days of sham stimulation after a 14-day wash-out period. The Coma Recovery Scale-Revised (CRS-R) and TMS-EEG were used to assess the levels of consciousness and cortical excitability before and after active and sham stimulation, respectively.
Ann Med Surg (Lond)
September 2025
Department of Neurosurgery, College of Medical Sciences, Bharatpur, Nepal.
Background: Chronic subdural hematoma (CSDH) is a common neurosurgical condition, particularly among the elderly, that often requires surgical drainage. Due to economic and logistical constraints, traditional closed-system drains are often impractical in low- and middle-income countries (LMICs). Foley catheter drainage has also been proposed as a cost-effective alternative, yet few studies have evaluated its safety and efficacy.
View Article and Find Full Text PDFAnn Med Surg (Lond)
September 2025
Department of internal medicine, Kist medical college, Nepal.
Introduction And Importance: Age-inconsistent brain atrophy refers to brain shrinkage that is not proportional to chronological age. This case report is first to report a young patient who developed age-inconsistent brain atrophy due to post cardiac arrest brain injury (PCABI). Due to limitations in the available data, we report our experience and novel magnetic resonance (MR) imaging changes in the brain over the course of 2 months.
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