Clinical and developmental aspects of small brain stem hematomas. Contribution of x-ray computed tomography
le Coz, P.; Woimant, F.; George, B.; Merland, J.J.; Haguenau, M.; Pepin, B.
Revue Neurologique (Paris) 142(1): 52-60
1986
ISSN/ISBN: 0035-3787 PMID: 3704428 Document Number: 276138
In a review of 16 cases, the authors emphasize that small brainstem haemorrhages, diagnosed by CT-scan, can have a good outcome, most often spontaneously. Twelve hematomas were in the pons, four in the mesencephalon. Several clinical features were remarkable: consciousness was not or moderately impaired, focal symptoms and signs predominantly neuro-ophthalmologic were present. Involvement of the cranial nerves and long tracts occurred rarely in isolation. Arterial hypertension was the usual cause (50 p. cent); one normotensive patient with neurological disorders prior to the bleeding had an arteriovenous malformation, demonstrated angiographically. In two cases an obstructive hydrocephalus was surgically treated. Expected advances from CT-scan and magnetic resonance imaging (M.R.I.) are discussed.