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Intrapontine Hemorrhage

Intrapontine Intracerebral Hemorrhage


Presentation

  • Get a quick and memorable overview of anatomy, pathophysiology, and clinical presentation from the precision and beauty of Netter and Netter-style plates that highlight key neuroanatomical and neurologic concepts.[books.google.de]
  • Patients present with sudden and precipitous neurological deficits.[radiopaedia.org]
  • Skull base chondrosarcomabe is to be included in the differentials of a young patient presenting with signs consistent with pontine haemorrhage. Publication Journal of College of Physicians and Surgeons Pakistan[ecommons.aku.edu]
  • HEART Coronary artery disease was present (right coronary 50% occluded, left anterior descending 30% occluded and left circumflex 60% occluded). No intracardiac thrombus was present. There were atherosclerotic changes in the aorta.[jnnp.bmj.com]
  • Superior Foville syndrome is a rare clinical presentation of stroke and presented a rich semiological feature of the posterior cerebral fossa. Introduction The Superior Foville Syndrome is a rare clinical feature of stroke or brain hemorrhage.[panafrican-med-journal.com]
Pain
  • Seite 415 - AD (2000) Cytoarchitectonic and immunohistochemical characterization of a specific pain and temperature relay, the posterior portion of the ventral medial nucleus, in the human thalamus.[books.google.de]
  • Page 415 - AD (2000) Cytoarchitectonic and immunohistochemical characterization of a specific pain and temperature relay, the posterior portion of the ventral medial nucleus, in the human thalamus.[books.google.com]
  • Gasperini syndrome may be accompanied by ipsilateral trigemino-autonomic head pain.[thejournalofheadacheandpain.biomedcentral.com]
  • Symptoms [ edit ] Damage to the following areas produces symptoms (from medial to lateral): Structure affected Effect Lateral spinothalamic tract Contralateral loss of pain and temperature from the trunk and extremities.[en.wikipedia.org]
  • Case report A 30-year-old well-nourished male presented to the emergency department with a complaint of acute headache with pain in the right eye and simultaneous weakness and numbness on his left side.[e-tjo.org]
Anosmia
  • Seite 130 - The syndrome of anosmia with hypogonadotropic hypogonadism: a genetic study of 18 new families and a review. Am J Med Genet 1983;15:417-435. ‎ Seite 121 - Jeffery DR, Mandler RN, Davis LE. Transverse myelitis.[books.google.de]
  • Page 130 - The syndrome of anosmia with hypogonadotropic hypogonadism: a genetic study of 18 new families and a review. Am J Med Genet 1983;15:417-435. ‎ Page 121 - Jeffery DR, Mandler RN, Davis LE. Transverse myelitis.[books.google.com]
Miosis
  • Diffusely spreading hypertensive haemorrhages are of apo-plectiform onset with fast developing coma, and show disturbance of vegetative function (disturbance of respiration, cardiac dysrhythmias, hyperthermia, hypertension), miosis and other neuroophthalmologic[ncbi.nlm.nih.gov]
  • Mild ptosis with concurrent miosis oculus dexter was also found. A neurological examination revealed left hemiplegia, left hemiparesthesia, left-side sensory ataxia, right facial palsy, and right facial analgesia.[e-tjo.org]
  • […] vomiting, and vertigo Cochlear nuclei and intraaxial nerve fibers Hearing loss - ipsilateral central deafness Middle & inferior cerebellar peduncle Ipsilateral limb and gait ataxia Descending sympathetic tract Ipsilateral Horner's syndrome (ptosis, miosis[en.wikipedia.org]
  • Neurologic examination demonstrated a decreased level of consciousness, bilateral miosis, horizontal gaze paralysis, right ptosis, dysarthria, left hemiplegia, and left tongue deviation.[omicsonline.org]
Stroke
  • , stroke related psychiatric disorders, and other rare causes of stroke disorder. * A comprehensive source that thoroughly examines the neurological manifestations of stroke * A guide to highly studied topics, including stroke complications, syndromes[books.google.de]
  • Gain fresh perspectives and up-to-date insights from the world’s leading authorities on the pathophysiology, diagnosis, and management of stroke.[books.google.de]
  • Like all strokes, brain stem strokes produce a wide spectrum of deficits and recovery.[strokeassociation.org]
  • National Institute of Neurological Disorders and Stroke Preventing stroke (Medical Encyclopedia) Stroke - discharge (Medical Encyclopedia) [ Read More ][icdlist.com]
Neurologic Manifestation
  • This intensive handbook is meant to give clinicians a source reference that will enable them to gain a thorough knowledge and understanding of the clinical features and management of the many neurological manifestations of stroke disorder.[books.google.de]
Disturbance of Consciousness
  • Good prognosis was associated with alertness or only slight disturbance of consciousness, normal respiration, positive light reflex, normal heart rate and haematoma[aic.cuhk.edu.hk]
  • Vascular malformations are the origin of circumscribed pontine haematomas with slowly progressing disturbance of consciousness and brain stem symptoms with variable course exhibiting multiple remissions and recurrences.[ncbi.nlm.nih.gov]
Long Tract Signs
  • Depending on the speed at which the hematoma enlarges and the exact location, presentation may include 1,2 : decreased level of consciousness (most common) long tract signs including tetraparesis cranial nerve palsies seizures Cheyne-Stokes respiration[radiopaedia.org]
Ocular Bobbing
  • Spontaneous downward eye movements - ocular bobbing - imply preservation of rostral brainstem gaze centres. smaller unilateral basal pontine lesions show contralateral hemiparesis, often with ataxia in the limbs affected. lateral tegmental pontine lesions[gpnotebook.co.uk]

Workup

  • METHODS: Review of all patients with acute pontine hemorrhage admitted to a single tertiary center from 1990 to 2002 who underwent a diagnostic workup including brain magnetic resonance imaging (MRI).[ncbi.nlm.nih.gov]
  • Methods: Review of all patients with acute pontine hemorrhage admitted to a single tertiary center from 1990 to 2002 who underwent a diagnostic workup including brain magnetic resonance imaging (MRI).[karger.com]

Treatment

  • Access the comprehensive, expert clinical guidance you need to recognize the clinical manifestations of stroke, use the latest laboratory and imaging studies to arrive at a diagnosis, and generate an effective medical and surgical treatment plan.[books.google.de]
  • Experience of the optic neuritis treatment trial. Neurology 1997:49:1404-1413. ‎[books.google.de]
  • Tap into additional treatment information with more clinical vignettes that provide "real-life" illustrative case evaluations.[books.google.de]
  • Key Words: Pontine hematoma ; Surgical treatment ; Conservative treatment[jkns.or.kr]

Prognosis

  • […] that prognosis is related to size of the haematoma level of consciousness pupillary abnormalities.[aic.cuhk.edu.hk]
  • Overall, PMSAH has an excellent prognosis with better outcomes compared to aneurysmal SAH 1,2,4 .[radiopaedia.org]
  • Treatment and prognosis Pontine hemorrhages have a poor prognosis, with large bleeds being almost universally fatal. Open surgical evacuation of the clot is usually not performed, although stereotactic clot aspiration has been advocated by some 5 .[radiopaedia.org]
  • "Duret hemorrhage is not always suggestive of poor prognosis: a case of acute severe hyponatremia" . Am J Emerg Med . 23 (7): 908–10. doi : 10.1016/j.ajem.2005.07.014 . PMID 16291454 .[en.wikipedia.org]
  • Determination of the baseline and fol- low-up ICH and IVH volumes on NCCT was performed using Analyze Direct 11.0 software” Keywords Brainstem CT angiography Intracerebral hemorrhage Pontine Prognosis Spot sign Author Affiliation(s) 1 Department of Clinical[analyzedirect.com]

Etiology

  • Etiology 95% of cases have a normal cerebral angiogram and the source of bleeding is not identified; the cause is thought to be a venous bleed. This is referred to as non-aneurysmal perimesencephalic SAH .[radiopaedia.org]
  • The treatment depends on the etiology found, so it is important to realize a complete work up. Competing interests The authors declare no competing interest.[panafrican-med-journal.com]
  • Other associated conditions are hepatic dysfunction / liver transplantation, malnutrition Sites Most commonly central pons Extrapontine sites are cerebellum and lateral geniculate, regions of extensive gray white matter apposition Pathophysiology / etiology[pathologyoutlines.com]
  • Anterior cerebral artery infarction and aneurysms are common etiologies. The clinical features include reflex grasping, groping, and compulsive tool manipulation by the dominant right hand.[neurologyindia.com]
  • Chimowitz MI, Furlan AJ, Sila CA, Paranandi L, Beck GJ: Etiology of motor or sensory stroke: A prospective study of the predictive value of clinical and radiological features. Ann Neurol 1991;30:519–525.[karger.com]

Epidemiology

  • Hsu PK, Rigamonti D, Huhn SL (1993) Epidemiology of cavernous malformations. In: Awad IA, Barrow DL (eds) Cavernous malformations. American Association of Neurological Surgeons, Park Ridge IL, pp 13–23 Google Scholar 4.[springerlink.com]
  • Definition / general Central pontine and extrapontine myelinolysis are complications of treatment of marked hyponatremia Terminology Also termed osmotic demyelination syndrome Epidemiology Occurs most commonly in setting of chronic alcoholism ( 40% of[pathologyoutlines.com]
Sex distribution
Age distribution

Pathophysiology

  • Gain fresh perspectives and up-to-date insights from the world’s leading authorities on the pathophysiology, diagnosis, and management of stroke.[books.google.de]
  • . * A comprehensive source that thoroughly examines the neurological manifestations of stroke * A guide to highly studied topics, including stroke complications, syndromes, and stroke related psychiatric disorders * A better understanding of the pathophysiological[books.google.de]
  • Get a quick and memorable overview of anatomy, pathophysiology, and clinical presentation from the precision and beauty of Netter and Netter-style plates that highlight key neuroanatomical and neurologic concepts.[books.google.de]

Prevention

  • Stay up to date on hot topics such as mechanisms of action of commonly used drugs, neuronal angiogenesis and stem cells, basic mechanisms of spasm and hemorrhage, prevention of stroke, genetics/predisposing risk factors, and much more.[books.google.de]
  • […] manifestations of stroke * A guide to highly studied topics, including stroke complications, syndromes, and stroke related psychiatric disorders * A better understanding of the pathophysiological basis of strokes that will help practitioners better diagnose, prevent[books.google.com]
  • Highlights new information on genetic risk factors; primary prevention of stroke; infectious diseases and stroke; recovery interventions such as robotics, brain stimulation, and telerehabilitation; and trial design.[books.google.ro]

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