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Objective: To explore prospectively the relationship between the state of perimesencephalic cist and the degree of deformation of the midbrain on CT scanning and the outcome of the patients with acute craniocerebral injury.Methods: The CT scan features including the states of perimesencephalic cists, the deformations of the midbrain and the ratios of the occipitofrontal diameter and the transverse diameter of the midbrain of 132 cases were measured. The GOS of the patients 3 months after trauma were regarded as outcome. Conclusions: The state of the compressed perimesencephalic cist (<1 mm) and the deformation of the midbrain 05- significantly indicate unfavorable outcome of the patients with acute craniocerebral injury.