le Coz P, Woimant F, George B, Merland J J, Haguenau M, Pepin B
Rev Neurol (Paris). 1986;142(1):52-60.
In a review of 16 cases, the authors emphasize that small brainstem haemorrhages, diagnosed by CT-scan, can have a good outcome, most often spontaneously. Twelve hematomas were in the pons, four in the mesencephalon. Several clinical features were remarkable: consciousness was not or moderately impaired, focal symptoms and signs predominantly neuro-ophthalmologic were present. Involvement of the cranial nerves and long tracts occurred rarely in isolation. Arterial hypertension was the usual cause (50 p. cent); one normotensive patient with neurological disorders prior to the bleeding had an arteriovenous malformation, demonstrated angiographically. In two cases an obstructive hydrocephalus was surgically treated. Expected advances from CT-scan and magnetic resonance imaging (M.R.I.) are discussed.
在对16例病例的回顾中,作者强调,经CT扫描诊断出的小脑干出血通常能有良好的预后,多数情况下是自发的。12处血肿位于脑桥,4处位于中脑。有几个临床特征值得注意:意识未受影响或仅有中度受损,存在以神经眼科症状为主的局灶性症状和体征。颅神经和长束单独受累的情况很少见。动脉高血压是常见病因(50%);1例血压正常但出血前有神经系统疾病的患者有血管造影显示的动静脉畸形。2例梗阻性脑积水接受了手术治疗。文中还讨论了CT扫描和磁共振成像(MRI)未来可能取得的进展。