Predictors of 30day mortality and 90day functional recovery after primary pontine hemorrhage. Spontaneous primary pontine hemorrhage pph accounts for about 10% of. Hypertrophic olivary degeneration secondary to pontine. Its popularity has increased over recent years because of excellent clinical results as well as a favourable side effect profile. The etiology in this case is thought to be hypertensive patient sbp was 190 mmhg at time of presentation. At stoke onset he was rushed to a local emergency room where he received a ct scan. If you have problems viewing pdf files, download the latest version of adobe reader. The other showed sensory dysaesthesia on the right side of the body, followed by dysaesthesia of cheirooral distribution. Recent advances in neuroimaging, organised stroke care, dedicated neuroicus, medical and surgical management have improved the management of ich. Pontine hemorrhage recoverytreatment neurology medhelp.
Pontine peacemaking circles and urban youth pdf haemorrhage still has a poor prognosis goto et al, 1980. Pontine haemorrhage represents approximately 6% of intracranial haemorrhages. Pontine haemorrhage causing disturbance of taste springerlink advertisement. Haematomas were located in the dorsolateral tegmentum of the pons, detected by computed tomographic scan. Pontine hemorrhage my husband is a survivor of a pontine hemorrhage. The survival rate was 40% in 10 patients suffering hemorrhage into the pons who were admitted to an acute care facility. Level of consciousness on admission and haemorrhage size were the most consistent predictors of mortality in patients with pontine haemorrhage. Pontine haemorrhage due to chondrosarcoma of the skull base. Hypertension is the usual cause for primary hemorrhage into the pons or cerebellum in the absence of trauma or of displacement of vessels by pressure from above.
The clinical picture of olanzapine overdose can be. Two cases of pure sensory stroke due to pontine haemorrhage are reported. Pontine hemorrhage definition of pontine hemorrhage by. Factors determining the outcome of pontine hemorrhage in the. However, on mri of the brain, he was found to have pontine haemorrhage. Good outcome in a patient with massive pontine hemorrhage. Introductionin a general study of pontine hemorrhage, four cases were observed in patients who had had operations for supratentorial tumors. Ask or answer a question about symptoms or diseases at one of our free interactive user forums.
Full details about pontine and brain stem haemorrhage in coma. A case series of 26 patients suggests that prognosis is related to. There is a common presumption that pontine haemorrhage is inherently associated with poor outcome. Hypertrophic olivary degeneration due to pontine hemorrhage.
Providing adequate prophylactic treatment to prevent secondary brain injury resulted in a very good recovery at the 6month followup. Pontine haemorrhage causing disturbance of taste springerlink. Current management of spontaneous intracerebral haemorrhage. If you have a medical story then we want to hear it. However, this case report gives a different result. For language access assistance, contact the ncats public information officer. Symptoms can include headache, onesided weakness, vomiting, seizures, decreased level of consciousness, and neck stiffness. The clinical manifestations of pontine hemorrhage neurology. Uncontrolled hypertension htn is the most common cause of spontaneous ich.
Pontine stroke, also known as pons stroke, is a type of brain stem stroke that often creates chronic side effects. Pdf management of brainstem haemorrhages researchgate. Pontine hemorrhage is usually caused by uncontrolled systemic hypertension. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease. Primary pontine hemorrhages are relatively rare when compared to supratentorial cerebral hemorrhage. Duret haemorrhage an overview sciencedirect topics. Predictors of dysphagia in acute pontine infarction stroke. See detailed information below for a list of 6 causes of pontine haemorrhage, symptom checker, including diseases and drug side effect causes. Fourteen months earlier, he had had a pontine hemorrhage figure 1a, causing left arm paralysis, from which he recovered. Pure sensory stroke due to pontine haemorrhage springerlink.
Management of post bilateral pontine haemorrhage with ayurveda. My husband has a medical background and wants to know exactly what caused the damage to the eyes the pontine hemorrhagestroke or fluid buildup on the brain. You can also select additional symptoms for more specificity. Little is known about the frequency and the clinical characteristics of neurogenic dysphagia in pontine strokes. What is pontine strokecausessymptomstreatmentrecovery. Factors determining the outcome of pontine hemorrhage in the absence of surgical intervention. Because of the close proximity of pons to the cranial nerve nuclei and vascular anomalies, patients with primary pontine hemorrhages show various atypical manifestations. Central pontine myelinolysis cpm is a neurological condition involving severe damage to the myelin sheath of nerve cells in the pons an area of the brainstem. Management of post bilateral pontine haemorrhage with. Thrombophilia screening revealed reduced protein c activity at 36% normal range 70 140 and reduced free protein s. Pdf among spontaneous intracranial haemorrhages, primary. These hematomas grow quickly and assume a round or oval shape, usually. Pdf factors determining the outcome of pontine hemorrhage in. The purpose of this report is to illustrate the role of ayurvedic treatment methodology for management of such neurological disorders.
Subsequent cta cow not shown did not reveal an underlying vascular malformation. This article will discuss the following facts about pontine stroke. Early airway protection, control of malignant htn, urgent reversal. A good prognosis was found with no or mild disturbance of consciousness, normal pupils, and transverse diameter of the haematoma 20 mm or less. Less frequently these hemorrhages accompany a bleeding disorder or a vascular malformation. Factors determining the outcome of pontine hemorrhage in. No brain stem lesion was seen on the initial brain. Pontine haemorrhage disguised as bells palsy bmj case. Ct findings and clinical features as markers for patient. Jul 23, 2019 pontine stroke, also known as pons stroke, is a type of brain stem stroke that often creates chronic side effects understanding the symptoms and treatment for pontine stroke is crucial, because timely treatment can help save a persons life. Can waiting for treatment contribute to disabilities following a pontine hemorrhage. Clinical features and outcomes of the patients with pontine hemorrhage. Intracerebral hemorrhage ich, also known as cerebral bleed, is a type of intracranial bleed that occurs within the brain tissue or ventricles.
Most of the patients with poor prognosis became comatose within two hours of onset. Pontine and brain stem haemorrhage in coma leela dsouza. Intracerebral haemorrhage ich is the most devastating and disabling type of stroke. The content on this site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. Image of the moment pontine infarction due to intracranial. Figure 16 is a sagittal section of a large pontine hematoma found at necropsy. The list below shows all pairs of cooccurring symptoms for pontine haemorrhage for which we have cause information in our database.
The prognosis of basis tegmentum type haemorrhage is midway between the others. We report here an uncommon case of primary pontine hemorrhage with complete clinical recovery and with resolution of the hematoma as visualized by computerized tomography ct. May 29, 2014 a case of pontine haemorrhage following lumbar myelography using iohexol is described. Pm was a 31 year old lady who suffered from an attack. Genetic and rare diseases information center gard po box 8126, gaithersburg, md 208988126 toll free. The eyes were badly affected, along with numbness on the entire left side of his body, but my husband wants to know if he will ever recover his eyesight. Isolated facial nerve palsy is a common presentation of bells palsy, but rarely seen in pontine lesions. Pontine haemorrhage following iohexol lumbar myelography. The prognosis of primary pontine haemorrhage was previously reported to be very poor, but the use of ct scanning has allowed the detection of small pontine haemorrhages that would previously not be detected. Correlation with the size of the haematoma, neurological findings and prognosis was studied in 26 cases of hypertensive pontine haemorrhage, using ct.
Report of a case a 38yearold woman with no history of previous illness was hospitalized because of acute onset of. The brain stem is responsible for breathing, heart function, digestion and alertness. A case of pontine haemorrhage following lumbar myelography using iohexol is described. In both cases, infarcts in the pons are characterized by interesting. In this study, we sought to identify predictors for dysphagia in a cohort of patients with isolated pontine infarctions. Pdf on jan 1, 2012, takafumi nishizaki and others published factors.
Nontraumatic pontine hemorrhages occur in about 10% of all nontraumatic intracranial hemorrhage ich cases 1. The patient being reported is a middleaged man who developed isolated facial nerve palsy and was initially treated as bells palsy. Know the causes, symptoms, treatment, recovery period, survival rate. Pontine infarcts and hemorrhages request pdf researchgate. Pontine haemorrhage mimicked by an olanzapine overdose.
Ct findings and clinical features as markers for patient outcome in. Pontine haemorrhage ph comprises approximately 10% of intracerebral haemorrhages ich. Theynotethat the prognosisforthemassivetypeof haemorrhage is poor, but the prognosis for longtermsurvival andfunctional recoveryoftegmentum type cases is good. In a total of 1437 pontine haemorrhage patients included in the 20 studies, the overall rate for early allcause mortality was 48. Subsequently the patient was initially treated with. Stress, inducing transient hypertension during the procedure, with superimposed neurotoxicity from contrast medium iohexol is suggested as a possible mechanism. We report a man with acute disturbance of taste in whom mri showed a small haemorrhage in the medial lemniscus of the pons. Pontine infarcts are often part of a large ischemia involving the brainstem, although infarcts may be restricted to the pons. Pontine hemorrhage, a form of intracranial hemorrhage, is most commonly due to long standing poorlycontrolled chronic hypertension. Pontine hemorrhage genetic and rare diseases information. Calculations of the volume o af pontine hemorrhage and its correlations to clinical symptoms were not in. The factors related to death and functional recovery after primary pontine hemorrhage pph in koreans has not been well defined.
Pontine hemorrhage risks, symptoms and leading causes treato. Hypertrophic olivary degeneration secondary to pontine haemorrhage article in journal of clinical neuroscience 227 april 2015 with 8 reads how we measure reads. Pontine stroke is a type of stroke that happens when the blood flow in the brain stem is disrupted. The eyes were badly affected, along with numbness on the entire left side of his body, but my husband wants. One showed the cheirooral syndrome on the left side. Corneomandibular reflex in a patient with pontine hemorrhage without impaired consciousness duration. Pontine hemorrhage following cranial surgery for supratentorial. Predictors of surgical results in patients with primary pontine. Primary pontine hemorrhage with complete recovery jama. Pontine hemorrhage risks, symptoms and leading causes. Predictors of 30day mortality and 90day functional. Mirroring this increased olanzapine use has been a rise in the number of nonaccidental overdoses. Takafumi nishizaki, norio ikeda, shigeki nakano, takanori sakakura, masaru abiko, tomomi okamura. The aim of the present study was to analyze the predictive value of clinical and neuroradiologic parameters concerning the outcome of patients with pph.
Jul 16, 2009 a useful article about pontine and brain stem haemorrhage in coma. On the other side, the homogeneous cohort of magnetic resonance imagingconfirmed pontine infarction is a strength of our study. These hematomas grow quickly and assume a round or oval shape, usually destroying the center of the tegmentum and base of the pons. In addition to the classic pontine hematoma syndrome characterized by coma, quadriparesis, and eventual demise, two more benign syndromes arising from hemorrhage confined to one side of the pons were also recognized. Report of a case a 38yearold woman with no history of previous illness was hospitalized because of. Intracerebral hemorrhage in young adults rikujaakko koivunen academic dissertation to be publicly discussed with the permission of the medical faculty of the university of helsinki in lecture hall 1, haartman institute, haartmaninkatu 3, helsinki, on th november 2015, at 12 noon. Department of neurosurgery, ube industries central hospital, ube, japan. Each symptom link shows a list of diseases or conditions that have both symptoms. We report here an uncommon case of primary pontine hemorrhage with complete clinical recovery and with resolution of the hematoma as visualized by.
The overall mortality rate of primary pontine hemorrhage pph in recent studies is 4050%. Massive pontine hemorrhage with comatose condition has a poor prognosis and bad outcome despite adequate surgical treatment. In conclusion, our data show that dysphagia is a frequent symptom among patients with pontine infarction. Tashiro department of neurosurgery baba memorial hospital 4244 fumaohigashi, hamadera sakai, osaka japan department of radiology baba memorial hospital osaka japan abstract we report a man with acute disturbance of taste in whom mri showed a small haemorrhage in the. Understanding the symptoms and treatment for pontine stroke is crucial, because timely treatment can help save a persons life.
Olanzapine, an atypical antipsychotic of the thienobenzodiazepine class, has been on the market since 1996. The uncus of the temporal lobe herniates over the free edge of the tentorium. In many cases bleeding is present in both the brain tissue and the. This case report documents the management of residual paralysis due to a rare and fatal disease hemorrhagic leukoencephalitis with ayurveda. Pontine haemorrhage disguised as bells palsy bmj case reports. Histopathology of the mass revealed that it was a chondrosarcoma. Her right hemiparesis had nearly resolved by day 15, prior to discharge. Know the causes, symptoms, treatment, recovery period, survival rate and prognosis of pontine stroke.