Precedence of Parenchymal Enhancement on CT Angiography to a Fatal Duret Hemorrhage

We report a case of fatal duret hemorrhage (DH) in a patient with acute tentorial subdural hematoma and bilateral chronic subdural hematoma along the cerebral hemispheres. Preoperative CT angiography (CTA) revealed prominent parenchymal enhancement in the ventral pontomesencephalic area. After burr-...

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Bibliographic Details
Published inJournal of Korean Neurosurgical Society Vol. 53; no. 6; pp. 380 - 382
Main Authors Sim, Ki-Bum, Na, Dong Gyu, Park, Ji Kang
Format Journal Article
LanguageKorean
Published 2013
Subjects
CT
Duret hemorrhage
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Summary:We report a case of fatal duret hemorrhage (DH) in a patient with acute tentorial subdural hematoma and bilateral chronic subdural hematoma along the cerebral hemispheres. Preoperative CT angiography (CTA) revealed prominent parenchymal enhancement in the ventral pontomesencephalic area. After burr-hole drainage, a large hemorrhage developed in this area. The parenchymal enhancement in the CTA may reflect the pontomensencephalic perforating vessel injury, and may be a sign of impending DH of acute transtentorial downward herniation. Previous use of aspirin and warfarin might have potentiated the process of DH and increase the extent of the bleed.
Bibliography:KISTI1.1003/JNL.JAKO201334460141208
ISSN:2005-3711
1598-7876