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Lateral segmental brainstem hemorrhages

Department of Neurology, Michael Reese Hospital, and University of Chicago, Pritzker School of Medicine, Chicago, IL.

Hypertensive intracerebral hemorrhages are caused by leakage from small penetrating branches of larger cerebral vessels. In the brainstem, these vessels penetrate in a median, paramecia, and more lateral orientation. As illustrated by three patients reported here, hemorrhage from the lateral vessels may be limited to the lateral tegmentum, or spread to the dorsal basis points. The syndrome is relatively consistent and includes (1) ipsilateral conjugate gaze palsy, (2) ipsilateral intern clear ophthalmologic, (3) small reactive pupils with a smaller pupil ipsilateral to the lesion, (4) limb ataxia of the cerebellar type (often greater ipsilaterally), (5) contra lateral hemiplegia, and (6) contra lateral severe hemisensory loss. Patients frequently survive after lateral tegmental hemorrhages, which can be diagnosed by CT.

Address correspondence and reprint requests to Dr. Caplan, Chairman, Department of Neurology, Michael Reese Hospital and Medical Center, 2900 South Ellis, Room 380 Main Reese, Chicago, IL 60616.

Accepted for publication August 13, 1981.

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