447injury are probably due to increased intracranial pressure,3 but there was no question of this in our patient either symptomatically or on computed tomography.The most logical explanation for the haematoma in our patient was shearing injury to the blood vessels supplying the lower midbrain and upper pons with no damage to brain stem tissue, which might explain why he remained alert and conscious.'Crompton MR. Brainstem lesions due to closed head injury. Lancet
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