Skip to main content
SpringerLink
Log in
Book cover

Primary and Secondary Brain Stem Lesions pp 14–27Cite as

Cerebral Mass Displacements. Part II Clinical Findings in Primary and Secondary Brain Stem Lesions

  • Chapter

  • 51 Accesses

Part of the book series: Acta Neurochirurgica ((NEUROCHIRURGICA,volume 40))

Abstract

Damage to the brain stem is manifested clinically in functional disorders which can be assigned either in isolation or in combination with the following categories:

  • — disorders of consciousness

  • — stimulation or deficit manifestations on the part of the cranial nerve nuclei located in the brain stem and the pertinent nerve tracts and connectional systems

  • — stimulation or deficit manifestations on the part of the autonomic centers

  • — losses of functions based on lesions to the ascending and descending tract systems passing through the brain stem.

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

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

Part II

  1. Agnoli AL, Cristante L, Busse O, Feistner H (1980) Brain herniation by cranial computer tomography: clinical radiological correlations. In: Anatomy-physiology in CT. Kugler Medical Publications, Amstelveen

    Google Scholar 

  2. Agnoli AL, Laun A, Busse O, Schoch R (1980) Computerized tomography in brain stem haemorrhage. Diagnostic and prognostic aspects. Lecture: IXth Congress of European Society of Neuroradiology, Brussels

    Google Scholar 

  3. Amphoux M, Sevin A (1975) Traumatisms cérébraux et focalisations intracraniennes. Agressologie 16, A: 47–53

    PubMed  Google Scholar 

  4. Ansari K (1974) Les hémorrhagies secondaires du tronc cérébral. Arch Suiss de Neurol Neurochir Psychiat 114, fasc 1, 1–28

    CAS  Google Scholar 

  5. Ansink BJJ (1962) Physiological and clinical investigations into four brain stem reflexes. Neurology (Minneap) 12: 320

    CAS  Google Scholar 

  6. Arieff AJ, Pyzik SW (1953) The ciliospinal reflex in injuries of the spinal cord in man. Arch Neurol Psychiat (Chic) 70: 621

    CAS  Google Scholar 

  7. Auer LM et al (1980) Predicting letal outcome after severe head injury—a computer-assisted analysis of neurological symptoms and laboratory values. Acta Neurochir (Wien) 52: 225–238

    Article  CAS  Google Scholar 

  8. Auer LM et al (1980) Relevance of CT-scan for the level of ICP in patients with severe head injury. In: Shulman K et al (eds) Intracranial pressure IV. Springer, Berlin Heidelberg New York, pp 45–47

    Chapter  Google Scholar 

  9. Babić B et al (1979) Prognostic factors in acute head injuries—brain stem contusion during the first week. Acta Neurochir (Wien) 1 [Suppl] 28: 153–157

    Google Scholar 

  10. Barge M, Ohanessian J, Baum L, Benabid AL, Chirossel JP (1977) Valeur diagnostique et pronostique des réflexes du tronc cérébral dans les comas post-traumatiques graves. Neurochirurgie 23: 227–238

    PubMed  CAS  Google Scholar 

  11. Becker DP et al (1977) The outcome from severe head injury with early diagnosis and intensive management. J Neurosurg 47: 491–502

    Article  PubMed  CAS  Google Scholar 

  12. Benezech J et al (1979) Apport des potentiels évoqués du tronc cérébral (PET) pour l’étude clinique et le pronostic des comas traumatiques. Corrélations avec les réflexes du tronc cérébral. Neurochirurgie 25 (4): 219–223

    PubMed  CAS  Google Scholar 

  13. Berger MS et al (1985) Outcome from severe head injury in children and adolecents. J Neurol 62: 194–199

    CAS  Google Scholar 

  14. Bogousslavsky J, Meienberg O (1987) Eye-movement disorders in brain stem and cerebellar stroke. Arch Neurol 44 (2): 141–148

    Article  PubMed  CAS  Google Scholar 

  15. Brendler SJ, Selverstone B (1970) Recovery from decerebration. Brain 93: 381–392

    Article  PubMed  CAS  Google Scholar 

  16. Bricolo A (1976) Prolonged post-traumatic coma. In: Vinken PJ, Bruyn GW (eds) Handbook of clinical neurology. North Holland Publishing Comp, Amsterdam, Oxford, vol 24, p 699

    Google Scholar 

  17. Bricolo A, Gentilomo A, Rosadini G, Rossi GF (1968) Long-lasting post-traumatic unconsciousness. Acta Neurol Scand 44: 512–532

    Article  Google Scholar 

  18. Bricolo A, Battistini N, Bergamini L et al (1975) A proposal for the clinical classification of acute coma due to organic cerebral lesions. J Neurosurg Sci 19: 113

    PubMed  CAS  Google Scholar 

  19. Bricolo A, Dolce G (1975) Evoluzioni cliniche del coma post-traumatico grave. Min Neurochir 13: 61

    Google Scholar 

  20. Bruce DA, Schut L, Bruno LA, Wood JH, Sutton LN (1978) Outcome following severe head injuries in children. J Neurosurg 48: 679–688

    Article  PubMed  CAS  Google Scholar 

  21. Bryan R, Weisberg L (1982) Prolonged survival with good functional recovery in 3 patients with computer tomographic evidence of brain stem haemorrhage. Comput Radiol 6 (1): 43–48

    Article  PubMed  CAS  Google Scholar 

  22. Buonaguidi R, Rossi B, Sartucci F, Ravelli V (1979) Blink reflexes in severe traumatic coma. J Neurol Neurosurg Psychiat 42: 470–474

    Article  PubMed  CAS  Google Scholar 

  23. Burns J et al (1980) Recovery following brain stem haemorrhage. Ann Neurol 7 (2): 183–184

    Article  PubMed  CAS  Google Scholar 

  24. Busse O, Agnoli A, Schoch P, Laun A (1981) Primary brain stem haematomas of vascular aethiology: clinical and CT-correlations. 12th World Congress of Neurology, Kyoto, Japan

    Google Scholar 

  25. Byuke O (1980) Facial reflex examination. A clinical and neurophysiological study on acustic tumours and brain displacement at the tentorial notch. Acta Neurol Scand [Suppl] 62 (76): 1–127

    Google Scholar 

  26. Carlsson C, Essen C von, Lörfren J (1968) Factors affecting the clinical course of patients with severe head injuries. Part 1: Influence of biological factors. Part 2: Significance of post-traumatic coma. J Neurosurg 29: 242

    Article  PubMed  CAS  Google Scholar 

  27. Clay SA, Ramseyer JC (1977) The orbicularis oculi reflex: pathologic studies in childhood. Neurology 27: 892–895

    PubMed  CAS  Google Scholar 

  28. Cooper PR et al (1979) Traumatically induced brain stem haemorrhage and the computerized tomographic scan: clinical, pathological and experimental observations. Neurosurg 4 (2): 115–124

    Article  CAS  Google Scholar 

  29. Le Coz P et al (1986) Aspects cliniques et evolutifs des haematomas circonscrits du tronc cérébral. Apport du scanner X. Rev Neurol (Paris) 142 (1): 52–60

    Google Scholar 

  30. Crompton MR (1966) Prolonged coma after head injury. The Lancet 938-940

    Google Scholar 

  31. Dengler R, Struppler A (1981) Beurteilung der Lokalisation und Ausdehnung von Hirnstammaffektionen mit Hilfe des Orbicularis-oculi-Reflexes. EEG EMG 12 (1): 50–55

    PubMed  CAS  Google Scholar 

  32. Denny-Brown D (1962) The midbrain and motor integration. Proc Roy Soc Med 55: 527

    PubMed  CAS  Google Scholar 

  33. Fisher CM (1969) The neurological examination of the comatouse patient. Acta Neurol Scand [Suppl] 36: 45

    Google Scholar 

  34. Fisher MA, Shahani BT (1979) Assessing segmental excitability after acute rostral lesions: II. The blink reflex. Neurology (Minneap) 29 (1): 45–50

    CAS  Google Scholar 

  35. Gennarelli TA et al (1982) Influence of the type of intracranial lesion on outcome from severe head injury. J Neurosurg 56: 26–32

    Article  PubMed  CAS  Google Scholar 

  36. Gerstenbrand F (1967) Das traumatische appallische Syndrom. Springer, Wien New York

    Google Scholar 

  37. Gerstenbrand F, Lücking CH (1970) Die akuten traumatischen Hirnstammschäden. Arch Psychiatr Nervenkr 213: 264–281

    Article  PubMed  CAS  Google Scholar 

  38. Gerstenbrand F (1970) Klinik und Therapie der akuten traumatischen Hirnstammschäden. Z ges Neurologie Psychiat 197: 105

    Google Scholar 

  39. Greenberg RP et al (1977) Evaluation of brain function in severe human trauma with multimodality evoked potentials. Part 1: Evoked brain injury potentials, methods and analysis. Part 2: Localisation of brain dysfunction and correlation with post traumatic neurological conditions. J Neurosurg 47 (2) 150–177

    Article  PubMed  CAS  Google Scholar 

  40. Greenberg RP et al (1979) Clinical findings associated with brain stem dysfunction: an electrophysiological study in severe human head trauma. In: Popp AJ et al (eds) Neural trauma. Raven Press, New York, pp 229–236

    Google Scholar 

  41. Greenberg RP et al (1981) Noninvasive localization of brain stem lesions in the cat with multimodality evoked potentials: correlation with human head-injury data. J Neurosurg 54 (6): 740–750

    Article  PubMed  CAS  Google Scholar 

  42. Herrmann D, Kunze K, Agnoli A (1982) Orbicularis Oculi-Reflexe in der Differentialdiagnose der Hirnstammsyndrome. In: Struppler A (Hrsg) Elektrophysiologische Diagnostik in der Neurologic G Thieme, Stuttgart New York, pp 246–247

    Google Scholar 

  43. Jellinger K (1968) Zur Neuropathologie des Komas und postkomatöser Encephalopathien. Wien Klin Wschr 80: 505–517

    PubMed  CAS  Google Scholar 

  44. Jellinger K, Gerstenbrand E, Pateisky K (1963) Die protrahierte Form der posttraumatischen Encephalopathie. Nervenarzt 34: 145–159

    PubMed  CAS  Google Scholar 

  45. Jellinger K, Seitelberger F (1970) Protracted post-traumatic encephalopathy. J Neurol Sci 10: 51–94

    Article  PubMed  CAS  Google Scholar 

  46. Jennett B, Teasdale G et al (1977) Severe head injuries in three countries. J Neurol Neurosurg Psychiat 40: 291–298

    Article  PubMed  CAS  Google Scholar 

  47. Jennett B, Teasdale G (1977) Aspects of coma after severe head injury. Lancet 23: 878–881

    Article  Google Scholar 

  48. Jennett B et al (1979) Prognosis of patients with severe head injury. Neurosurg 4: 283–289

    Article  CAS  Google Scholar 

  49. Jouvet M, Dechaume J (1967) Sémiologie des troubles de la conscience. Essay de classification. Rev Lyon Med 9: 961–968

    Google Scholar 

  50. Jouvet M (1969) Coma and other disorders of consciousness. In: Vinken PJ, Bruyn GW (eds) Handbook of clinical neurology, vol 3. North Holland, Amsterdam, pp 62–79

    Google Scholar 

  51. Kimura J (1970) Alterations of the orbicularis oculi reflex by pontine lesions. Arch Neurol (Chic) 22: 156–161

    Article  CAS  Google Scholar 

  52. Kimura J (1971) Electrodiagnostic study of brain stem. Stroke 2: 576–586

    Article  PubMed  CAS  Google Scholar 

  53. Kimura J (1973) The blink reflex as a test for brain stem and higher central nervous system function. In: Desmedt JE (ed) New developments in electromyography and clinical neurophysiology, vol 3. Karger, Basel, pp 682–691

    Google Scholar 

  54. Kistler JP, Hochberg FH et al (1975) Computerized axial tomography: Clinico-pathologic correlation. Neurology 25: 201–209

    PubMed  CAS  Google Scholar 

  55. Klug N (1982) Brain stem auditory evoked potentials in syndromes of decerebration, bulbar syndromes and in central death. J Neurol 227: 219–228

    Article  PubMed  CAS  Google Scholar 

  56. Klug N, Csécsei G, Rap Z (1982) Evoked potentials and blink reflex in clinical and experimental traumatic brain stem lesions. Excerpta Medica

    Google Scholar 

  57. Klug N (1983) Funktionsuntersuchungen des Hirnstammes im akuten Mittelhirnsyndrom unter Berücksichtigung vegetativer Größen während der Dezerebration. Habil-Schrift, Giessen

    Google Scholar 

  58. Klug N, Csécsei G (1985) Evoked potentials and brain stem reflexes. Neurosurg Rev 8(1): 83–84

    Article  Google Scholar 

  59. Klug N, Csécsei G (1985) Brain stem acoustic evoked potentials in the acute midbrain syndrome and in central death. In: Morocuti C, Rizzo PA (eds) Evoked potentials—neurophysiological and clinical aspects. Elsevier, Amsterdam New York Oxford, pp 203–210

    Google Scholar 

  60. Klug N (1986) Neurophysiological results (brain stem reflexes and evoked potentials) in primary and secondary brain stem disorders. In: Samii M (ed) Surgery in and around the brain stem and 3rd ventricle. Springer, Berlin Heidelberg New York London Paris Tokyo, pp 147–152

    Chapter  Google Scholar 

  61. Laun A, Agnoli AL (1980) Brain stem haemorrhages. In: Pia HW, Langmaid L, Zierski J (eds) Spontaneous intracerebral haematomas—advances in diagnosis and treatment. Springer, Berlin Heidelberg New York, pp 196–201

    Google Scholar 

  62. Laun A, Agnoli AL, Schönmayr R, Villagrasa J (1983) Morphological and CT-findings in traumatic brain stem haemorrhages—a contribution of pathophysiology of primary and secondary lesions. In: Villani R (ed) Advances in neuro-traumatology. JCS 612, Excerpta Medica, Amsterdam Oxford Princeton

    Google Scholar 

  63. Lyon LW, Kimura J, McCormick WF (1972) Orbicularis oculi reflex in coma: clinical, electrophysiological and pathological correlations. J Neurol Neurosurg Psychiat 35: 582–588

    Article  PubMed  CAS  Google Scholar 

  64. McNealy DE, Plum F (1962) Brain stem dysfunction with supratentorial mass lesions. Arch Neurol (Chic) 7: 10–32

    Article  Google Scholar 

  65. Ongerboer De Visser BW, Goor C (1976) Jaw reflexes and masseter myograms in mesencephalic and pontine lesions. J Neurol Neurosurg Psychiat 39: 90–92

    Article  PubMed  CAS  Google Scholar 

  66. Ongerboer De Visser BW, Kuypers HG (1978) Late blink reflex changes in lateral medullary lesions. An electrophysiological and neuro-anatomical study of Wallenberg’s syndrome. Brain 101 (2): 285–294

    Article  PubMed  CAS  Google Scholar 

  67. Ottaviani F et al (1986) Auditory brain stem and middle latency auditory responses in the prognosis of severely head-injured patients. Electroencephalogr Clin Neurophysiol 65 (3): 196–202

    Article  PubMed  CAS  Google Scholar 

  68. Overgaard J, Petersen K, Christensen S et al (1973) Prognosis after head injury based on early clinical examination. Lancet 11: 631

    Article  Google Scholar 

  69. Pagni CA (1973) The prognosis of head injured patients in a state of coma with decerebrate posture. J Neurosurg Sci 17: 289–295

    Google Scholar 

  70. Pazzaglia P, Frank G, Frank F et al (1975) Clinical course and prognosis of acute post-traumatic coma. J Neurol Neurosurg Psychiat 38: 149–154

    Article  PubMed  CAS  Google Scholar 

  71. Perez-Dominguez E (1974) Les réflexes du tronc cérébral. Leur valeur dans l’étude des comas. Thèse, Université du Montpellier

    Google Scholar 

  72. Pia HW (1956) Die Einwirkung der Hirndrucksteigerung auf den Hirnstamm, ihre Klinik und Behandlung. Münch med Wschr 98: 1609–1612

    PubMed  CAS  Google Scholar 

  73. Pia HW (1957) Die Schädigungen des Hirnstammes bei den raumfordernden Prozessen des Gehirns. Acta Neurochir (Wien) [Suppl] 4, Springer, Wien

    Google Scholar 

  74. Rappaport M et al (1981) Evoked potentials and head injury. 2. Clinical applications. Clin Electroencephalogr 12 (4): 167–176

    PubMed  CAS  Google Scholar 

  75. Reeves AG, Posner JB (1969) The ciliospinal response in man. Neurology (Minneap) 19: 1145–1152

    CAS  Google Scholar 

  76. Rosenblum WI, Greenberg RP et al (1981) Midbrain lesions: frequent and significant prognostic feature in closed head injury. Neurosurg 9: 613–620

    Article  CAS  Google Scholar 

  77. Rossi GF (1965) Some aspects of the functional organisation of the brain stem: neurophysiological and neurosurgical observations. Copenhagen, IIIrd Int Congr Neurol Surg. Excerpta Medica, pp 117-122

    Google Scholar 

  78. Sancesario G et al (1984) Prognostic evaluation of brain stem haematomas: the role of CT scan and brain stem auditory evoked potentials. Acta Neurol Scand 70 (6): 396–406

    Article  PubMed  CAS  Google Scholar 

  79. Schoenhuber R et al (1983) Neurophysiological assessment in progressive supranuclear palsy (letter). Ital J Neurol Sci 4 (3): 363

    Article  PubMed  CAS  Google Scholar 

  80. Schönmayr R (1973) Übersicht über die klinisch wichtigen Fremdreflexe des Menschen. Diss TU München

    Google Scholar 

  81. Schönmayr R, Laun A, Agnoli AL, Busse O (19821) Spontaneous brain stem lesions. CT-findings and clinical data in respect to morbidity. Advances in Neurosurgery, vol 10. Springer, Berlin Heidelberg New York, pp 47–49

    Google Scholar 

  82. Snyder BD et al (1981) Neurologic prognosis after cardiopulmonary arrest: IV. Brain stem reflexes. Neurology (NY) 31 (9): 1092–1097

    CAS  Google Scholar 

  83. Stewart WA, Litten SP, Sheehe PR (1973) A prognostic model for brain stem injury. Surg Neurol 1: 303–310

    PubMed  CAS  Google Scholar 

  84. Struppler A, Dobbelstein H (1963) Elektromyographische Untersuchungen des Glabellareflexes bei verschiedenen neurologischen Störungen. Nervenarzt 34: 347

    PubMed  CAS  Google Scholar 

  85. Tanaka Y, Kaga K (1980) Application of brain stem response in brain-injured children. Brain Dev 2 (1): 45–56

    PubMed  CAS  Google Scholar 

  86. Tandon PN, Bhatia R, Banerji AK (1973) Vestibulo-ocular reflex and brain stem lesions. A clinico-pathological study. Neurology (India) 193-199

    Google Scholar 

  87. Teasdale G, Jennett B (1974) Assessment of coma and impaired consciousness. A practical scale. Lancet 2: 81–83

    Article  PubMed  CAS  Google Scholar 

  88. Turazzi S, Alexandre A, Bricolo (1975) Incidence and significance of clinical signs of brain stem traumatic lesions. J Neurosurg Sciences 19: 215–222

    CAS  Google Scholar 

  89. Uziel A et al (1982) Clinical applications of brain stem auditory evoked potentials in comatose patients. Adv Neurol 32: 195–202

    PubMed  CAS  Google Scholar 

  90. Vapalahti M, Troupp H (1971) Prognosis for patients with severe brain injuries. Br Med J: 404-406

    Google Scholar 

  91. Verier A et al (1984) Evaluation clinique et pronostique d’un coma post-traumatique selon le nineau de souffrance du tronc cerebral. Sem Hop Paris, 60 (14): 1014–1019

    PubMed  CAS  Google Scholar 

  92. Walshe FMR (1957) States of consciousness in neurology. Acta Med Belg 141-145

    Google Scholar 

  93. Werf AJM van der (1979) Brain stem injuries. European association of neurosurgical societies. Neurosurgical Course

    Google Scholar 

  94. Zee DS (1986) Brain stem and cerebellar deficits in eye movement control. Trans Ophtalmol Soc UK 105 (Pt 5): 599–605

    Google Scholar 

  95. Zuccarello M et al (1983) Importance of auditory brain stem responses in the CT diagnosis of traumatic brain stem lesions. AJNR 4 (3): 481–483

    PubMed  CAS  Google Scholar 

  96. Zuccarello M et al (1983) Traumatic primary brain stem haemorrhage. A clinical and experimental study. Acta Neurochir (Wien) 67 (1-2): 103–113

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurosurgery, University of Giessen, Federal Republic of Germany

    Robert Schönmayr

Authors
  1. Robert Schönmayr
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 1987 Springer-Verlag Wien

About this chapter

Cite this chapter

Schönmayr, R. (1987). Cerebral Mass Displacements. Part II Clinical Findings in Primary and Secondary Brain Stem Lesions. In: Primary and Secondary Brain Stem Lesions. Acta Neurochirurgica, vol 40. Springer, Vienna. https://doi.org/10.1007/978-3-7091-8941-2_2

Download citation

  • DOI: https://doi.org/10.1007/978-3-7091-8941-2_2

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-7091-8943-6

  • Online ISBN: 978-3-7091-8941-2

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation