Longitudinal Brain Stem Compression with Buckling

Introduction The purpose of this paper is to report some further observations on the morbid anatomy of longitudinal brain stem compression with buckling and to comment on the evidence that this deformity is responsible for the signs and symptoms of upper brain stem compression in a variety of patients. In an earlier paper1the syndrome of upper brain stem compression associated with large temporal lobe hernias through the hiatus in the tentorium cerebelli was described in some detail. The most essential features were a progressive global impairment of consciousness, loss of pupillary light reflexes, decerebrate rigidity spontaneously or in response to nociceptive stimuli, and a variable disturbance of the vital signs, the most frequent being an increase in the rate and depth of respiration. Hypertensive cerebral hemorrhage into the tegmentum of the midbrain produces identical signs and symptoms, and therefore it was concluded that this syndrome was for the