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KMID : 1001920130530060380
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Journal of Korean Neurosurgical Society
2013 Volume.53 No. 6 p.380 ~ p.382
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Precedence of Parenchymal Enhancement on CT Angiography to a Fatal Duret Hemorrhage
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Sim Ki-Bum
Na Dong-Gyu
Park Ji-Kang
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Abstract
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We report a case of fatal duret hemorrhage (DH) in a patient with acute tentorial subdural hematoma and bilateral chronic subdural hematoma along the cerebral hemispheres. Preoperative CT angiography (CTA) revealed prominent parenchymal enhancement in the ventral pontomesencephalic area. After burr-hole drainage, a large hemorrhage developed in this area. The parenchymal enhancement in the CTA may reflect the pontomensencephalic perforating vessel injury, and may be a sign of impending DH of acute transtentorial downward herniation. Previous use of aspirin and warfarin might have potentiated the process of DH and increase the extent of the bleed.
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KEYWORD
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Duret hemorrhage, CT
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