A case of duret hemorrhage demonstrated by computed tomography

摘要

Brainstem hemorrhage in descending transtentorial herniation is well known as Duret hemorrhage. However, CT or MRI rarely reveals Duret hemorrhage. The authors report a case of brainstem hemorrhage after craniotomy of spontaneous acute subdural hematoma. A 47-year-old man suffered sudden onset of severe headache and progressive consciousness disturbance. Initial CT scan demonstrated a right acute subdural hematoma and a marked shift of the midline structures to the left. Emergency craniotomy was performed but he remained comatose. CT scan after 8 days showed multiple petechial hemorrhages in the brainstem. We reported a rare case of Duret hemorrhage diagnosed by CT scan. Duret hemorrhage is almost fatal.