Precedence of Parenchymal Enhancement on CT Angiography to a Fatal Duret Hemorrhage.
10.3340/jkns.2013.53.6.380
- Author:
Ki Bum SIM
1
;
Dong Gyu NA
;
Ji Kang PARK
Author Information
1. Department of Neurosurgery, Jeju National University College of Medicine, Jeju, Korea.
- Publication Type:Case Report
- Keywords:
Duret hemorrhage;
CT
- MeSH:
Angiography;
Aspirin;
Cerebrum;
Drainage;
Glycosaminoglycans;
Hematoma, Subdural;
Hematoma, Subdural, Chronic;
Hemorrhage;
Humans;
Warfarin
- From:Journal of Korean Neurosurgical Society
2013;53(6):380-382
- CountryRepublic of Korea
- Language:English
-
Abstract:
We report a case of fatal duret hemorrhage (DH) in a patient with acute tentorial subdural hematoma and bilateral chronic subdural hematoma along the cerebral hemispheres. Preoperative CT angiography (CTA) revealed prominent parenchymal enhancement in the ventral pontomesencephalic area. After burr-hole drainage, a large hemorrhage developed in this area. The parenchymal enhancement in the CTA may reflect the pontomensencephalic perforating vessel injury, and may be a sign of impending DH of acute transtentorial downward herniation. Previous use of aspirin and warfarin might have potentiated the process of DH and increase the extent of the bleed.
