Brainstem hemorrhage

Case contributed by Bálint Botz
Diagnosis certain

Presentation

Sudden loss of vision and then consciousness. CPR during transport. Anisocoria. IC bleeding?

Patient Data

Age: 40 years
Gender: Male
ct
  • Large mesencephalic and pontine bleeding causing perifocal edema and breaking into the fourth ventricle.
  • Resultant effacement of the infratentorial extracerebral liquor spaces. 
  • Hypodense areas in supratentorial bilateral deep white matter in line with chronic small vessel ischemic changes. 

Case Discussion

Primary brainstem hemorrhages are characterized by a dramatic presentation and rapid clinical progression due to the secondary mass effect. 

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