Traumatic Brainstem Hemorrhage Presenting with Hemiparesis.
10.3340/jkns.2009.45.3.176
- Author:
Young Bem SE
1
;
Choong Hyun KIM
;
Koang Hum BAK
;
Jae Min KIM
Author Information
1. Department of Neurosurgery, Hanyang University Guri Hospital, Guri, Korea. kch5142@hanyang.ac.kr
- Publication Type:Case Report
- Keywords:
Brain stem hemorrhage;
Head trauma;
Hemiparesis
- MeSH:
Adult;
Brain;
Brain Stem;
Brain Stem Hemorrhage, Traumatic;
Contusions;
Craniocerebral Trauma;
Head;
Head Injuries, Closed;
Hematoma;
Hemorrhage;
Humans;
Magnetic Resonance Spectroscopy;
Male;
Paresis;
Prognosis;
Skull;
Skull Fracture, Depressed;
Spinal Cord;
Spine
- From:Journal of Korean Neurosurgical Society
2009;45(3):176-178
- CountryRepublic of Korea
- Language:English
-
Abstract:
Traumatic brainstem hemorrhage after blunt head injury is an uncommon event. The most frequent site of hemorrhage is the midline rostral brainstem. The prognosis of these patients is poor because of its critical location. We experienced a case of traumatic brainstem hemorrhage. A 41-year-old male was presented with drowsy mentality and right hemiparesis after blunt head injury. Plain skull radiographs and brain computerized tomography scans revealed a depressed skull fracture, epidural hematoma, and hemorrhagic contusion in the right parieto-occipital region. But, these findings did not explain the right hemiparesis. T2-weighted magnetic resonance (MR) image of the cervical spine demonstrated a focal hyperintense lesion in the left pontomedullary junction. Brain diffusion-weighted and FLAIR MR images showed a focal hyperintensity in the ventral pontomedullary lesion and it was more prominent in the left side. His mentality and weakness were progressively improved with conservative treatment. We should keep in mind the possibility of brainstem hemorrhage if supratentorial lesions or spinal cord lesions that caused neurological deficits in the head injured patients are unexplainable.
