A review of pneumoencephalography and clinical data in a large group of patients has shown that severe head injury may be followed by a consistent clinical-radiological syndrome. A prolonged period of unconsciousness is a characteristic initial feature of this syndrome. Clinically there is ataxia and dysarthria and, often, abnormal movements and oculomotor dysfunction. The characteristic radiological feature is an enlargement of the aqueduct of Sylvius. The clinical picture, together with the enlargement of the aqueduct, suggests that loss of neuronal and axonal substance in the midbrain is the probable pathology.
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