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All had reduced consciousness at presentation and did not respond to treatment.
For the 17 children who were started on aciclovir, 16 had a history of altered consciousness on presentation.
Rigau-Perez et al reported a high proportion of impaired consciousness at presentation and during disease progression [ 7].
The level of consciousness at presentation has been shown by other authors to be of great prognostic value [ 14, 20].
Age, diabetes mellitus, disseminated intravascular coagulation[ 4], impaired consciousness on presentation[ 4, 5], presence of shock and infection with phage type 95[ 1] have all been associated with a poor outcome by an univariate statistical analysis.
Patients with minor head injury include those with blunt injury to the head who have a normal or minimally altered level of consciousness on presentation at the emergency department.
All patients included in our analysis had key prognostic factors available describing age, level of consciousness on presentation, imaging findings, and baseline INR, allowing us to adjust for these in our multivariate models.
To further elucidate the influence of acidosis measured by arterial pH and effective serum osmolality on the level of consciousness at presentation, we determined the odds ratio of depressed sensorium in all 216 subjects by quartiles of pH and osmolality (see supplemental Fig. 1 in the online appendix).
Most strokes cause symptoms on one side of the body, but this patient had a sudden loss of consciousness, an unusual presentation.
No clinical or imaging feature has been conclusively established as predicting the prognosis, although impaired consciousness upon initial presentation is usually associated with a poor outcome [121, 125].
