Pontine Hemorrhage after Surgical Evacuation of Nontraumatic Subdural Hematoma.
- Author:
Ji Hun JANG
1
;
Byung Woo YOON
;
Eun Mi PARK
Author Information
1. Department of Neurology, College of Medicine, Seoul National University.
- Publication Type:Original Article
- Keywords:
Duret hemorrhage;
Anticoagulation;
Nontraumatic SDH;
Transtentorial herniation;
Pontine hemorrhage
- MeSH:
Brain;
Brain Neoplasms;
Brain Stem;
Dysarthria;
Female;
Hematoma;
Hematoma, Subdural*;
Hemorrhage*;
Humans;
Intracranial Pressure;
Magnetic Resonance Imaging;
Middle Aged;
Neurology;
Temporal Lobe;
Tricuspid Valve
- From:Journal of the Korean Neurological Association
1999;17(6):920-923
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Duret hemorrhage is characterized by an upper brainstem hemorrhage due to increased intracranial pressure by mass effect such as subdural hematoma or a brain tumor. The anteroposterior elongation and downward displacement of the upper brainstem by transtentorial herniation results in the compression and tearing of the paramedian perforating vessels that feed the upper brainstem tegmentum. The consequent hemorrhage that involves the upper brainstem renders recovery to be almost impossible. Following a tricuspid valve replacement surgery, a 56-year-old woman developed a left fronto-temporo-parietal nontraumatic subdural hematoma resulting in transtentorial herniation of the left mesial temporal lobe. A successful surgical evacuation of the hematoma was done with clinical improvement. Two days later, she was referred to neurology with an aggravated right side weakness, dysarthria, and a newly developed extraocular movement disturbance. A brain CT and MRI showed a pontine hemorrhage. We report a case of pontine hemorrhage, a Duret hemorrhage, after the surgical evacuation of nontraumatic subdural hematoma.
