Skip to main content

Advertisement

Log in

Frequency of primary brain stem lesions after head injuries

A CT scan analysis from 186 cases of severe head trauma

  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Summary

Analysis of level of brain stem dysfunction, evolution, and CT scan profile was made on 76 cases of head injuries with prolonged unconsciousness and without hemispheric focal lesion and midline shift on CT scan. Eleven cases were considered normal on CT scan. The CT scan aspect of primary brain stem lesion was identified in 31.5% of these series, and in 14.5% of all severe head traumas (186 cases), from which this series is taken. Primary and secondary CT scan profiles were observed whatever the clinical level of dysfunction and its evolution. Pontine lesions were mainly associated with haemorrhage in the brain stem and diffuse brain swelling; but minimal signs (cortical level) and benign outcome can also be related to axial haemorrhage. These results emphasize the frequency of primary brain stem lesions and the value of CT scan in head injuries.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Adams, H., Grahm, D. I., The Pathology of Blunt Head Injuries in Scientific Foundations of Neurology (Critchley, Mc. D., O'Leary, J. L., Jennett, B., Heinemann, W., eds.), pp. 478–495. London: Med. Books Ltd. 1972.

    Google Scholar 

  2. Barge, M., Ohanessian, J., Baum, L., Benabid, Al., Chirossel, J. P., Valeur diagnostique et pronostique des réflexes du tronc cérébral dans les comas posttraumatiques graves. Neurochirurgie23 (1977), 227–238.

    PubMed  Google Scholar 

  3. Britt, R. H., Herrick, M. K., Mason, R. T., Dorfman, L. J., Traumatic lesions of the ponto-medullary junction. Neurosurgery6 (1980), 623–631.

    PubMed  Google Scholar 

  4. Chodkiewicz, J. P., Creissard, P., Redondo, A., Vedrenne, C., Etude anatomoclinique de 150 traumatisés crânio-encéphaliques. Neurochirurgie18 (1972), 77–84.

    PubMed  Google Scholar 

  5. Clifton, G. L., Grossman, R. G., Makela, M. E., Miner, M. E., Ahndel, S., Sadhu, V., Neurological course and correlated computed tomography findings after severe closes head injury. J. Neurosurg.52 (1980), 611–624.

    PubMed  Google Scholar 

  6. Crompton, M. R., Brain stem lesions due to close head injury. Lancet1 (1971), 669–673.

    PubMed  Google Scholar 

  7. De Jong, W., Acute and chronic hypertension after lesions and transsections of the rat brain stem. Prog. Brain Res.47 (1977), 189–197.

    PubMed  Google Scholar 

  8. Espagno, C., La souffrance axiale du traumatisé crânien grave. Thèse médecine Toulouse 1977, No. 7.

  9. Fieschi, C., Battistini, N., Beduschi, A., Boselli, L., Rossanda, M., Regional cerebral blood flow and intraventricular pressure in acute head injuries. J. Neurol. Neurosurg. Psychiat.37 (1974), 1378–1388.

    PubMed  Google Scholar 

  10. French, B. N., Dublin, A. B., The value of CT in the management of 1,000 consecutive head injuries. Surg. Neurol.7 (1977), 171–183.

    PubMed  Google Scholar 

  11. French, B. N., Limitations and pitfalls of computed tomography in the evaluation of craniocerebral injury. Surg. Neurol.10 (1978), 395–401.

    PubMed  Google Scholar 

  12. Gilbert, J. J., Deonna, T., Unusual brainstem findings following closed head-injury. J. Ped.81 (1972), 343–346.

    Google Scholar 

  13. Graham, D. I., Adams, J. H., Ischaemia brain damage in fatal head injuries. Lancet1 (1971), 265–266.

    PubMed  Google Scholar 

  14. Hoff, J. T., Reis, D. K., Localization of regions mediating the Cushing response in CNS of cat. Arch. Neurol.23 (1970), 228–240.

    PubMed  Google Scholar 

  15. Ingvar, D. H., Gadea Ciria, M., Assessment of severe damage to the brain by multiregional measurement of cerebral blood flow in outcome of severe damage to the CNS. CIBA foundation 34 Elsevier 1975.

  16. Johnston, I. H., Johnston, J. A., Jennett, B., Intracranial pressure changes following head injury. Lancet2 (1970), 433–436.

    PubMed  Google Scholar 

  17. Langfitt, T. W., Tannanbaum, H. M., Kassel, N. F., The etiology of acute brain swelling following experimental head injury. J. Neurosurg.24 (1966), 47–56.

    PubMed  Google Scholar 

  18. Oppenheimer, D. R., Microscopic lesions in the brain following head injury. J. Neurol. Neurosurg. Psychiat.31 (1968), 299–306.

    PubMed  Google Scholar 

  19. Plum, F., Posner, J. B., Diagnostic de la stupeur et des comas. Paris: Masson. 1973.

    Google Scholar 

  20. Rowan, J. O., Brain stem blood flow during raised ICP. Acta Neurol. Scand.56, 64 (1977), 520–521.

    Google Scholar 

  21. Snoek, J., Jennett, B., Adams, J. H., Graham, D. I., Doyle, D., Computed tomography after recent severe head injury in patients without acute intracranial haematoma. J. Neurol. Neurosurg. Psychiat.42 (1979), 215–225.

    PubMed  Google Scholar 

  22. Tomlinson, B. E., Brain stem lesions after head injury. J. Clin. Path.23, Suppl. 4 (1970), 154–165.

    Google Scholar 

  23. Treip, C. S., Hypothalamic and pituitary injury. J. Clin. Path.23, Suppl. 4 (1970), 178–186.

    PubMed  Google Scholar 

  24. Valtonen, S., Troupp, H., Diffuse experimental brain injury: methods, histological findings, and changes in ICP and blood pressure. Acta neurochir. (Wien)31 (1974), 1–9.

    Google Scholar 

  25. Waga, S., Tochio, H., Sakakura, M., Traumatic cerebral swelling developping within 30 minutes after injury. Surg. Neurol.11 (1979), 191–193.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

George, B., Thurel, C., Pierron, D. et al. Frequency of primary brain stem lesions after head injuries. Acta neurochir 59, 35–43 (1981). https://doi.org/10.1007/BF01411189

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01411189

Keywords

Navigation