Spontaneous brain stem haematoma.

Thirty-four cases of brain stem haematoma encountered in the past eight years were surveyed. Among these, three cases had haematomas caused by cryptic vascular malformations. These cases underwent direct operation (removal of haematoma) and are well and working. The haematomas of the other 31 cases were probably of hypertensive origin. Among them, eight cases with haematomas less than one cm in the largest diameter as shown in the CT (Group A), survived more than one month and six of them are still living, four of them working. In cases with a haematoma more than one cm in the largest diameter on the CT (Groups B and C), 13 cases died and four cases are living. Indications for operation are doubtful even for cases of Group A, except for cases with acute hydrocephalus or cases with suspected cryptic angiomas.