Posttraumatic primary brainstem haematoma

Gościński, I; Kwiatkowski, St.; Cichoński, J; Moskała, Marek

doi:10.1007/bf01428496

Cited by 6 publications

(7 citation statements)

References 7 publications

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“…However, the prognostic value of GCS has been questioned [10,11,17] because outcome has not always correlated with GCS. Differences in the age of patients, types of injury, and statistical designs might account for this variability.…”

Section: Discussionmentioning

confidence: 98%

Traumatic brain stem lesions in children

Eder

Legat

Gruber

2000

Child's Nervous System

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Glasgow Coma Scale (GCS) scores on admission may be predictors of outcome in patients with brain injuries. This study correlated the outcomes of children with traumatic brain stem lesions with their initial GCS scores and morphological patterns of injury as shown on computed tomography (CT) or magnetic resonance (MR) imaging. During the last 16 years, we have treated 1,108 children with brain injuries. The entire series included only 21 (1.9%) children who had clinical signs of brain stem lesions with morphological correlates on CT or MR imaging. Clinical findings were assessed according to the GCS and compared with scores on the Glasgow Outcome Scale (GOS). Of these 21 children, 16 (76%) had morphological lesions seen on CT scans. In 5 (24%) of the children only the MR images revealed brain stem lesions and their CT scans were negative. Generalized severe brain swelling was present in 6 cases (28%). There was a significant difference in GOS scores between patients with initial GCS scores of 3 and 4 and those with GCS scores between 5 and 7 (P < 0.02). Children with intracranial pressure higher than 40 mmHg had poorer outcomes than patients whose intracranial pressure was lower, but the differences were not significant. Outcome did not correlate significantly with morphological patterns of injury or the presence of extracranial injuries. The GCS is a reliable indicator of severity of injury and of outcome in children with brain stem injuries. MR imaging was more sensitive than CT in detecting brain stem lesions.

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Section: Discussionmentioning

confidence: 98%

Traumatic brain stem lesions in children

Eder

Legat

Gruber

2000

Child's Nervous System

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“…10,11,13 Some authors have described it as a discrete entity attributable to a hyperextension mechanism of injury in persons who have sustained an impact on the forehead along the rostrocaudal axis. 3,4,10,13 This mass often coexists with other brain lesions, and affected patients are in a severe state (comatose) with a poor disease prognosis and thus subsumed in the category of those with severe brainstem injuries. [2][3][4]11 In some cases, however, an isolated type has been described with unexpectedly good recovery.…”

Section: Discussionmentioning

confidence: 99%

“…3,4,10,13 This mass often coexists with other brain lesions, and affected patients are in a severe state (comatose) with a poor disease prognosis and thus subsumed in the category of those with severe brainstem injuries. [2][3][4]11 In some cases, however, an isolated type has been described with unexpectedly good recovery. 3,10,13 The clinical presentation of these patients has included motor disorders (for example, ataxic hemiparesis).…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4]11 In some cases, however, an isolated type has been described with unexpectedly good recovery. 3,10,13 The clinical presentation of these patients has included motor disorders (for example, ataxic hemiparesis). 5 Brainstem contusions have a poor prognosis in terms of survival and functional outcome; apart from representing lesions of critical structures, they indicate the existence of diffuse axonal injury resulting from the classically described mechanism of violent strophic acceleration of the head.…”

Section: Discussionmentioning

confidence: 99%

“…5 Brainstem contusions have a poor prognosis in terms of survival and functional outcome; apart from representing lesions of critical structures, they indicate the existence of diffuse axonal injury resulting from the classically described mechanism of violent strophic acceleration of the head. 3,5,11 In cases of direct impact on the rostrocaudal axis, hyperextension of the neck causes cervical spine injuries. Uncommonly, sudden displacement of the brain can cause contusion of the anterior rostral midbrain.…”

Section: Discussionmentioning

confidence: 99%

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Traumatic midbrain hematoma in a patient presenting with an isolated palsy of voluntary facial movements

Bouras

Stranjalis²,

Sakas³

2007

JNS

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The authors report on the case of a young man with a mild head injury and an isolated palsy of voluntary facial movements, attributed to a midbrain traumatic hematoma. This exception to the generally accepted conjunction between brainstem contusion and poor prognosis pertains to a special entity of midbrain laceration due to hyperextension of the head, with minimal influence on the level of consciousness. The clinical presentation of this lesion with facial palsy sparing emotion-related movement has rarely been described and offers a clue for exploring the neuroanatomy of facial movement.

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