How to make the examination of brain and spinal injury patients
<Fast exam for CNS injury in comatose patient> Assess GCS scale. Check the pupils for size, position and reactivity to light Check for nasal CSF leak Check plantar reflexes Check passive muscle tone/deep tendon reflexes on limbs (only if you are sure there are no fractures) In the acute phase of spinal shock you'll have absent deep tendon reflexes and flaccid paresis, mimicking PNS damage. If the patient is alert a more detailed neuro physical is possible, even localize the height of spinal cord damage using dermatomes.