Duret hemorrhage Definition, Symptoms, Causes, Treatment

   

Duret hemorrhage is lesion occurred in the central area of brain i.e. mid brain and upper pons of brain stem. This condition is named after a scientist Henri Duret. The lesion in mid brain is appeared as small lineal area of bleeding. Duret hemorrhage occur secondary to increased intracranial pressure which raised due to formation of transtentorial pressure cone which is involved in in the front part of the cerebral peduncles which is known as cerebral cura. When the level of intracranial pressure increases above tentorium it may also involve other structures of midbrain. Due to this increased intracranial pressure, brain stem dislocation occurs and a groove is formed in the cerebral peduncle known as kernohan’s notch.


Duret hemorrhage should be diagnosed with great care. Various test are performed to diagnose Duret hemorrhage like medical imaging technique of computed tomography scan and magnetic resonance imaging. It is found to be difficult diagnosing Duret hemorrhage with other lesions. When brainstem is displaced due to stretching and tearing of branches of the basilar artery connected to pons it will lead to Duret hemorrhage. Duret hemorrhage cause many problems in routine life of patient and is proved fatal for life of patient.

Duret hemorrhage Definition, Symptoms, Causes, Treatment


Duret hemorrhage Causes

         
Duret hemorrhage is like small lesion occurred in central part of brain which can be caused due to many reasons. The main causes reported are as follows:
It most commonly occur due to displacement of the brain stem in downward direction due to any trauma or injury. Injury may be external or internal leading to Duret hemorrhage. Herniation of hippocampus gyrus also occur along with brain stem displacement through the tentorial notch. Also through the acute hematoma. Edema can also lead to Duret hemorrhage. Other reported causes are trauma, tumor which may be malignant or benign and abscess.

Duret hemorrhage Symptoms

           
Duret hemorrhage is a fatal condition but people with recovery are also reported. Lesion or small lineal area of bleeding may cause serious problems in body. As it is caused due to displacement of brainstem or its head named pons so all the functions of pons are disturbed. Patient can lose his control over many involuntary functions like breathing, communication and different sensations like hearing, smell, taste and body balance. Patient is not able to communicate with others with no proper language control and cannot even walk with proper balance of body.


Duret hemorrhage Treatment

           
All the traumatic brain injuries including Duret hemorrhage is irreversible and cannot be cured at once. If treatment therapy works, it takes time to recover. But patient after Duret hemorrhage cannot get fully recover but with some abnormalities. Treatment option do not contain surgery because it is a very sensitive case to operate and get successful surgery. Instead medication therapy is used to reduce the symptoms and control bleeding. Blood thickening agents are prescribed and patient is transferred to intensive care unit. Patients who survive through Duret hemorrhages may recover with some disabilities like inability to talk and walk and breathing problems.

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