title: Spontaneous midbrain hemorrhage: report of seven new cases.
abstract: Spontaneous midbrain hemorrhage is a unique brain-stem vascular lesion. Sixty-six cases have been reported in the literature, to which we add seven. Of the total of 73 patients reviewed, most presented acutely (66%), but subacute (22%) and chronic onsets (12%) also occurred. Neuro-ophthalmologic abnormalities were found in 88% of patients. Some alteration of consciousness and headache occurred in most patients. Hemiparesis, hemisensory loss, and ataxia were less frequent manifestations. Vascular malformations were suspected or proved in 37% of patients, hypertension was present in 21%, and a bleeding diathesis was noted in 5%. No underlying cause was apparent in 37%. Most patients improved with supportive care only. At follow-up, 23% of patients had no neurologic deficits. In 51% of patients, minor neurologic deficits persisted, related chiefly to cranial nerves III and IV. Moderate deficits persisted in 16% of patients, and 5% of patients died.
authors.affiliation: Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota 55905.
authors.forename: M J
authors.initials: MJ
authors.lastname: Link
authors.forename: J D
authors.initials: JD
authors.lastname: Bartleson
authors.forename: G
authors.initials: G
authors.lastname: Forbes
authors.forename: F B
authors.initials: FB
authors.lastname: Meyer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002543:Cerebral Hemorrhage / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008636:Mesencephalon; D008875:Middle Aged