[A case of a dramatic recovery of hypertensive hemorrhage in the mid-pons].
A 50-year-old female who had a past history of non-treated hypertension, demonstrated a coma on arrival. CT revealed a high density lesion measuring 23 mm in transverse diameter and 15 mm in height at the ventral mid pons without breaking into a fourth ventricle or extending to the midbrain. She required mechanical ventilation support. Her consciousness improved on the 2nd hospital day. She showed tetra-plegia, which was especially dominant on her right side. Her symptoms gradually improved until she could stand and she was eventually discharged on the 41st hospital day. At 90 days after the initial presentation, an enhanced head MRI showed the absorption of the hematoma and no existence of any vascular malformation was observed. We herein report a case who dramatically recovered from a hypertensive pontine hemorrhage, despite the fact that she demonstrated several risk factors for a poor prognosis. The fact that the size of the hematoma was not so huge, and the location of the hematoma spared both the ascending reticular activating system and the nuclei, may explain the favorable outcome in this case.
Tsujita
Yujiro
Y
Department of Traumatology and Critical Care Medicine, National Defense Medical College, Saitama, Japan.
Yanagawa
Youichi
Y
Takasu
Akira
A
Takemoto
Masa-Aki
MA
Sakamoto
Toshihisa
T
Okada
Yoshiaki
Y
Katoh
Hiroshi
H
D002543:Cerebral Hemorrhage / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D011149:Pons; D011379:Prognosis; D020127:Recovery of Function; D012121:Respiration, Artificial; D014057:Tomography, X-Ray Computed