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Japanese

Locked-in Syndrome due to Primary Brainstem Injury:A Case Report Shunsuke YAMANISHI 1 , Hirotomo TANAKA 1 , Hirohito MIYAMOTO 1 , Shotaro TATSUMI 1 , Eiji KOHMURA 2 1Department of Neurosurgery, Steel Memorial Hirohata Hospital 2Department of Neurosurgery, Kobe University Graduate School of Medicine Keyword: locked-in syndrome , primary brainstem injury , traumatic brainstem hemorrhage , magnetic resonance imaging , MRI pp.1255-1259
Published Date 2019/12/10
DOI https://doi.org/10.11477/mf.1436204112
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 Most cases of the primary brainstem injuries(PBSI)are fatal, and disturbance of consciousness is often prolonged even if lifesaving is obtained. The mechanisms of PBSI are as follows:diffuse axonal injury from acceleration/deceleration, shear strain at the midbrain, direct injury of neurovascular structures by tentorial margin, and lower brainstem injury by hyperextension of the cervical vertebrae. Though we can use both CT and MRI to diagnose, MRI is more helpful than CT in detecting, localizing, and characterizing PBSI. When the location of PBSI is limited in the ventral side of pons, it may occasionally result in locked in syndrome(LIS). Generally it is difficult to diagnose LIS with severe trauma due to the rarity of this syndrome caused by head injury.

 Here, we report a case of an elderly man with traumatic brainstem hemorrhage, who transiently presented LIS and finally improved.


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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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