[Computerized tomography findings and the clinical course in infratentorial trauma]

Clinical examination of severe brain injuries often suggests involvement of the brain stem and pontine structures not only via functional but also via structural lesions. Computer tomographic evidence of infratentorial trauma, however appears comparably rarely. 32 of 436 brain injured patients examined by CT showed traumatic infratentorial lesions. We examined these patients with regard to the distribution of structural damage, place of primary impact of force, incidence of skull fractures and accompanying supratentorial injuries, initial clinical status and clinical outcome. All but 2 patients were primarily unconscious. The lethal outcome in 7 patients was presumably due to the traumatic involvement of supratentorial structures. Patients with mainly infratentorial lesions--even with large epidural haematoma--showed a good recovery and fair rehabilitative outcome if the operation was performed immediately.