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Pontine haemorrhage

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Pontine haemorrhage

Prognosis

The prognosis of primary pontine haemorrhage was previously reported to be very poor, but the use of CT scanning has allowed the detection of small pontine haemorrhages that would previously not be detected

A case series of 26 patients suggests that prognosis is related to

  • size of the haematoma

  • level of consciousness

  • pupillary abnormalities.

Patients with a poor prognosis became comatose within 2 hours of onset, their pupils were dilated bilaterally, pin-point or anisocoric and the transverse diameter of the haematoma was over 20 mm.

These findings are similar to the findings from a series of 32 brainstem haemorrhages, except with respect to the size of the haematoma. The patients were divided into 3 groups on the basis of eventual outcome. Approximately 1/3 died within 1 month, 1/3 were severely disabled (most were alert, quadiplegic and communicated only with great difficulty) and 1/3 had only minimal neurological disability. Good prognosis was associated with alertness or only slight disturbance of consciousness, normal respiration, positive light reflex, normal heart rate and haematoma <2.5 cm.

 

©Charles Gomersall, April, 2014 unless otherwise stated. The author, editor and The Chinese University of Hong Kong take no responsibility for any adverse event resulting from the use of this webpage.
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