A study of the vestibulo-ocular reflex with the use of the cold caloric stimulation of Kobrak was made in 33 patients having symptoms of transtentorial pressure cone, secondary to increased intracranial pressure from various causes.
The conditions demonstrated by the 33 patients included: acute head injuries 17, C.V.D. 14, parasagittal meningioma I and hydrocephalus 1; and these were divided into two groups: caloric positive 17 and negative 16, according to the vestibulo-ocular responses.
Chronological neurological findings, vital signs and prognosis were observed in all cases and marked differences were noted between the two groups.
The irreversible coma seemed to develop at the stage of change over from the caloric positive to negative.
The mortality rate was low(5.9%) in the caloric positive group even those having dilated pupil and high in the caloric negative group.
Some of the caloric negative group showed miosis until right before the terminal stage.
It is believed that the vestibulo-ocular reflex could be used as an additional valuable test in the clinical diagnosis of irreversible coma.