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[Hemorrhage in the quadrigeminal plate--a case report]
T Sugawara1, Y Ishibashi, T Ishibashi
1Division of Neurosurgery, Omiya Red Cross Hospital, Japan.
No Shinkei Geka. Neurological Surgery
|September 1, 1987
Summary
This case study details a rare survival of a pediatric patient with quadrigeminal plate hemorrhage, likely caused by a cryptic microvascular malformation. Prompt intervention improved neurological deficits, highlighting the importance of timely management for midbrain bleeds.
Area of Science:
- Neurology
- Neurosurgery
- Radiology
Background:
- Midbrain hemorrhage is a rare and often fatal condition.
- Hemorrhage in the quadrigeminal plate, a specific region of the midbrain, presents unique diagnostic and therapeutic challenges.
Observation:
- A 13-year-old boy presented with acute coma, tetraplegia, facial palsy, and ophthalmoplegia following severe headache and vertigo.
- Initial CT scans revealed hemorrhage in the midbrain and ambient cistern, with no abnormal vessels detected on vertebral angiography.
Findings:
- Continuous ventricular drainage led to gradual improvement in consciousness, ophthalmoplegia, and speech.
- Follow-up CT identified a small high-density spot in the right quadrigeminal plate, suggesting a cryptic microvascular malformation as the bleeding source.
Implications:
- This case underscores the potential for survival and recovery in pediatric quadrigeminal plate hemorrhage with prompt intervention.
- The findings suggest cryptic microvascular malformations as a potential etiology for such hemorrhages.
- Early management, including cerebrospinal fluid diversion, can significantly improve neurological outcomes.