Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Precedence of Parenchymal Enhancement on CT Angiography to a Fatal Duret Hemorrhage

  • Sim, Ki-Bum (Department of Neurosurgery, Jeju National University College of Medicine) ;
  • Na, Dong Gyu (Human Medical Imaging and Intervention Center) ;
  • Park, Ji Kang (Department of Radiology, Jeju National University College of Medicine)
  • Received : 2012.11.30
  • Accepted : 2013.06.19
  • Published : 2013.06.28
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Abstract

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.

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References

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