PERSISTENT ABSENCE OF AUDITORY BRAIN-STEM RESPONSES WITH PRESERVED HEARING AND RECOVERY FROM A PROLONGED COMATOSE STATE

A patient with hypertensive intracerebellar haemorrhage, who recovered from impending tonsillar herniation with emergency haematoma evacuati on, showed persistent absence of auditory brainstem responses. The pat ient demonstrated a preserved stapedius reflex and hearing after recov ery, indicating that the auditory brainstem pathway was not completely disrupted. We suggest that the loss of the auditory brainstem respons e (ABR) could be accounted for by impulse asynchrony along the auditor y brainstem pathway. The existence of such a case implies that persist ent absence of the ABR is not always indicative of irreversible brains tem damage and a poor outcome following severe brain injury.