Allan H. Ropper, M.D. N Engl J Med 2012; 367:746-752August 23, 2012
A 49-year-old female passenger was thrown against the doorframe during an automobile accident. After being pulled from the car, she opened her eyes intermittently, moaned, and had flexion withdrawal of her limbs (Glasgow Coma Scale score, 8).
Her pupils were 5 mm in diameter and reactive to light. Her blood pressure was 165/85 mm Hg, her heart rate 112 beats per minute, and her breathing regular. After her spine was stabilized, she was conveyed to an intensive care unit (ICU). In the ICU, she no longer opened her eyes, had flexion posturing of her arms, and made no verbal . . .
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