Locked-in syndrome after head and neck trauma.

Ten patients became locked-in after head and neck trauma. Five had a prompt onset due to either direct trauma or secondary infarction of the brainstem. A delay of 6 to 48 hours in four other patients was probably the interval between vertebral artery damage and vertebrobasilar arterial occlusion. The last patient sustained ischemia and compression of the cerebral peduncles from tentorial herniation.