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The first case of traumatic locked‐in syndrome caused by direct damage to the brainstem and not by vascular occlusion of the basilar artery is presented. The lesion consisted of cavitary necrosis of the ventral pontomedullary junction and bilateral disruption of the sixth cranial nerves. Other regions of brainstem damage are described and correlated with the patient's neurological deficits. The damage is thought to be due primarily to mechanical stretching occurring during sudden hyperextension injury.
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Britt et al. (1977) studied this question.
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