Anoxic brain injury physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Physical examination involves a thorough neurologic evaluation, with a focus on the extent of involvement of the brainstem.

Serial neurologic examinations are critical in the assessment of long term prognosis.

The presence of peristently dilated pupils is a poor prognostic sign ^[1]. It should be noted that both catecholamines and atropine, can affect pupillary size, and confound the assessment of pupillary size.

The brainstem is more resistant to hypoperfusion that the cerebral cortex, and if the brainstem does not recover, the cerebral cortex is not likely to recover. The presence of brainstem reflexes is therefore critical to recovery. Preservation of brainstem function is indicated by the presence of blinking, coughing, gagging, sneezing, and yawning.

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