[Electro-neurological correlations in early stages of posttraumatic comatose states. I. The EEG at different stages of acute traumatic secondary midbrain and bulbar brain syndrome (author's transl)].

165 EEG were analysed from 140 patients in posttraumatic coma with secondary traumatic midbrain and bulbar brain syndrome. The EEG-pattern was related to the stage of midbrain or bulbar brain syndrome caused by supratentorial brain shift. There was a close relation between EEG-pattern and the grade of rostro-caudal deterioration. A decrease in the number of different EEG-patterns was associated with increasing intracranial pressure. An unfavourable state of coma was indicated by the disappearance of sleep or sleep-like activities, alternating pattern and loss of reactivity. In deep stages of midbrain syndrome the neurological examination reveals no lateralizing signs at all. The EEG gives the only hint to a local cerebral lesion. EEG abnormalities due to the herniation itself interferred with the EEG-changes due to secondary circulatory, respiratory and metabolic encephalopathies. In such cases the above mentioned regularities were slurred.