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Lateral tegmental brainstem hemorrhages

L R Caplan, J A Goodwin

    Neurology
    |March 1, 1982
    PubMed
    Summary
    This summary is machine-generated.

    Hypertension intracerebral hemorrhages from lateral brainstem vessels cause a consistent syndrome. Early CT diagnosis aids in managing these often survivable hemorrhages.

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    Area of Science:

    • Neurology
    • Neurosurgery
    • Vascular Neurology

    Background:

    • Hypertension is a leading cause of intracerebral hemorrhage (ICH).
    • Cerebral ICH commonly involves the basal ganglia, thalamus, pons, and cerebellum.
    • Brainstem hemorrhages, particularly from lateral penetrating vessels, present unique clinical syndromes.

    Observation:

    • Hemorrhage from lateral brainstem penetrating vessels can affect the lateral tegmentum or dorsal basis pontis.
    • Three illustrative patient cases are presented.
    • Clinical presentation includes ipsilateral conjugate gaze palsy, ipsilateral internuclear ophthalmoplegia, and ipsilateral miosis.

    Findings:

    • Associated findings include ipsilateral limb ataxia, contralateral hemiplegia, and contralateral severe hemisensory loss.

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  • The described neurological deficit pattern is consistent with lateral tegmental hemorrhages.
  • Computed tomography (CT) is effective for diagnosing these hemorrhages.

    • Implications:

    • Recognition of this specific syndrome aids in localizing brainstem lesions.
    • Prompt diagnosis via CT can facilitate timely and appropriate patient management.
    • Understanding the vascular anatomy and hemorrhage patterns improves clinical outcomes for hypertensive brainstem bleeds.