Primary brainstem injury without persistent coma and decerebrate rigidity. Report of 2 cases

Two patients with blunt head injury were examined by CT scanning. It was found that there was brainstem hemorrhage with unremarkable changes in the other parts of the brain. Physical examination showed signs of upper brainstem lesion such as discoordination, bilateral Babinski signs, and internuclear ophthalmic palsy without persistent coma and decerebrate rigidity. The diagnosis of primary brainstem injury, well healed, was established. Basing on the results of these 2 cases, we believe that primary brainstem injury does exist, but it is not necessarily associated with persistent coma and decerebrate rigidity. CT scanning for diagnosing such cases is emphasized.