Mesencephalic hemorrhages: clinical and computed tomographic correlations.

We reviewed the clinical and CT findings in six patients with mesencephalic hematomas. All patients were normotensive. Headache and vomiting preceded impairment of consciousness. In all patients, unequal pupils reacted poorly to light but retained the near response. Upgaze was impaired in all patients. CT showed a unilateral nonenhancing midbrain hematoma in all cases and intraventricular blood in five. Four-vessel angiography in all cases showed no neoplasm, angioma, or aneurysm. All patients survived with persistent pupillary abnormalities and restriction of upward gaze.