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brainstem hemorrhage
Etiology:
1) hypertension (most common)
2) bleeding diatheses
3) pharmacologic anticoagulation
Pathology:
- most commonly small penetrating vessels bleeding into the pons
Clinical manifestations:
- headache
- vomiting more common in women
- focal neurologic deficits
- diplopia, vertigo, tinnitus, hyperacusis, tremor, dysarthria, dystonia, incoordination, cranial nerve palsy, hyperthermia, breathing dysfunction, long-tract signs [1]
- disorder of arousal
- coma
Laboratory: urine toxicology for cocaine
Radiology:
- neuroimaging (MRI)
Management:
- surgery reserved for selected cases where expertise available [1]
- prognosis is often poor
Related
subarachnoid hemorrhage (SAH)
General
hemorrhagic stroke
References
- Liebeskind DS and Levine SR
Brainstem hemorrhage
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