J S Raison1, G Bourbotte, T P Baum, M Pagès. 1. Service de neurologie, centre Gui-de-Chauliac, CHU de Montpellier, 80, avenue Fliche, 34295 Montpellier, France.
Abstract
INTRODUCTION: We report a retrospective series of 25 cases of brain stem hemorrhage. METHODS: Cases of spontaneous hemorrhage of the brain stem which were observed from 1990 to 2000 in a department of neurology were reviewed. Etiological factors, CT scan at admission, clinical signs and the course of the disease were analyzed retrospectively. RESULTS: There were 25 patients, 14 male and 11 female aged from 24 to 91. Fifteen hematomas were related to hypertension, four to coagulation disorders and two to a vascular malformation. The hemorrhage was located in the pons in 22 cases and in the midbrain in three cases. The death rate directly related to the hemorrhage was 14/25 (12 early and two delayed deaths). Prognosis factors were the size of the hemorrhage, a ventricular bleeding, disorders of consciousness and pupillary abnormalities on admission, the need for mechanical ventilation. CONCLUSION: In brain stem hemorrhage, the size of the hematoma is a more important prognosis factor than age or etiological factors.
INTRODUCTION: We report a retrospective series of 25 cases of brain stem hemorrhage. METHODS: Cases of spontaneous hemorrhage of the brain stem which were observed from 1990 to 2000 in a department of neurology were reviewed. Etiological factors, CT scan at admission, clinical signs and the course of the disease were analyzed retrospectively. RESULTS: There were 25 patients, 14 male and 11 female aged from 24 to 91. Fifteen hematomas were related to hypertension, four to coagulation disorders and two to a vascular malformation. The hemorrhage was located in the pons in 22 cases and in the midbrain in three cases. The death rate directly related to the hemorrhage was 14/25 (12 early and two delayed deaths). Prognosis factors were the size of the hemorrhage, a ventricular bleeding, disorders of consciousness and pupillary abnormalities on admission, the need for mechanical ventilation. CONCLUSION: In brain stem hemorrhage, the size of the hematoma is a more important prognosis factor than age or etiological factors.