brainstem hemorrhage

Etiology

• hypertension (most common)
• bleeding diatheses
• pharmacologic anticoagulation

Pathology

• most commonly small penetrating vessels bleeding into the pons

Clinical manifestations

• headache
• vomiting more common in women
• focal neurologic deficits
  • diplopia, vertigo, tinnitus, hyperacusis, tremor, dysarthria, dystonia, incoordination, cranial nerve palsy, hyperthermia, breathing dysfunction, long-tract signs
• disorder of arousal
  • coma

Laboratory

urine toxicology for cocaine

Radiology

• neuroimaging (MRI)

Management

• surgery reserved for selected cases where expertise available
• prognosis is often poor

More general terms

• hemorrhagic stroke

Additional terms

• subarachnoid hemorrhage (SAH)