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INTRAPEDUNCULAR HEMORRHAGE OF THE BRAIN: Successful Operative Approach, with Evacuation of Clot and a Seven and One-Fourth Year Observation Period

INTRAPEDUNCULAR HEMORRHAGE OF THE BRAIN: Successful Operative Approach, with Evacuation of Clot... Abstract A CASE is reported of recurrent hemorrhage into the left cerebral peduncle, with adjacent pressure on the cerebral aqueduct, culminating in an acute surgical emergency. An operative approach, with successful evacuation of the hemorrhagic clot from the peduncle, is described. At the time of this report, seven years and three months later, the patient was leading a normal life, with minimal residual symptoms. Intrapeduncular hemorrhage is not uncommon. The resulting clinical syndromes have been named after Weber, Millard-Gubler, Gruber, Benedict and Parinaud. The onset is frequently sudden, and the results are serious. If the hemorrhage is large, death is immediate; if the hemorrhage is small, the adjacent edema subsides, and there is delayed incomplete recovery with permanent residual disability.1a The peduncle is roughly trapezoidal, its two sides representing the two peduncles, its dorsal top the tegmentum and its ventral base the basilar portion. The aqueduct pierces the center of References 1. Grinker, R. R.: Neurology , Springfield, Ill., Charles C Thomas, Publisher, 1945 2. Neuro-Anatomy of Mid-Brain, pp. 38-39 3. Clinical Syndromes of Mid-Brain Lesions, p. 326. 4. Freeman, W., and Jaffe, D.: Occlusion of the Superior Cerebellar Artery , Arch. Neurol. & Psychiat. 46:115-126 ( (July) ) 1941. 5. Rowbotham, G. F.: Small Aneurysm Completely Obstructing Lower End of Aqueduct of Sylvius , Arch. Neurol. & Psychiat. 40:1241-1243 ( (Dec.) ) 1938. 6. Trelles, J. O.; Suarez, L., and Mendez, M.: Un caso anatomo-clínico de síndrome de Benedikt , Rev. neuro-psiquiat. 1:51-84, 1938 7. Arch. latino. de neurol. 1:112-114, 1940 8. Institute of Living Series 8, no. 110, 1940. 9. Naffziger, H. C.: Brain Surgery, with Special Reference to Exposure of the Brain Stem and Posterior Fossa: The Principle of Intracranial Decompression and the Relief of Impactions of the Posterior Fossa , Surg., & Obst. 46:241-248 ( (Feb.) ) 1928. 10. Manufactured by Pilling & Company, Philadelphia. 11. Bailey, P.: Concerning the Technic of Operations for Acoustic Neurinoma , Zentralbl. f. Neurochir. 4:1-5 ( (Jan.) ) 1939. 12. Horrax, G.: Extirpation of a Huge Pinealoma from a Patient with Pubertas Praecox: A New Operative Approach , Arch. Neurol. & Psychiat. 37:385-397 ( (Feb.) ) 1937. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology & Psychiatry American Medical Association

INTRAPEDUNCULAR HEMORRHAGE OF THE BRAIN: Successful Operative Approach, with Evacuation of Clot and a Seven and One-Fourth Year Observation Period

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References (10)

Publisher
American Medical Association
Copyright
Copyright © 1949 American Medical Association. All Rights Reserved.
ISSN
0096-6754
DOI
10.1001/archneurpsyc.1949.02310120092007
Publisher site
See Article on Publisher Site

Abstract

Abstract A CASE is reported of recurrent hemorrhage into the left cerebral peduncle, with adjacent pressure on the cerebral aqueduct, culminating in an acute surgical emergency. An operative approach, with successful evacuation of the hemorrhagic clot from the peduncle, is described. At the time of this report, seven years and three months later, the patient was leading a normal life, with minimal residual symptoms. Intrapeduncular hemorrhage is not uncommon. The resulting clinical syndromes have been named after Weber, Millard-Gubler, Gruber, Benedict and Parinaud. The onset is frequently sudden, and the results are serious. If the hemorrhage is large, death is immediate; if the hemorrhage is small, the adjacent edema subsides, and there is delayed incomplete recovery with permanent residual disability.1a The peduncle is roughly trapezoidal, its two sides representing the two peduncles, its dorsal top the tegmentum and its ventral base the basilar portion. The aqueduct pierces the center of References 1. Grinker, R. R.: Neurology , Springfield, Ill., Charles C Thomas, Publisher, 1945 2. Neuro-Anatomy of Mid-Brain, pp. 38-39 3. Clinical Syndromes of Mid-Brain Lesions, p. 326. 4. Freeman, W., and Jaffe, D.: Occlusion of the Superior Cerebellar Artery , Arch. Neurol. & Psychiat. 46:115-126 ( (July) ) 1941. 5. Rowbotham, G. F.: Small Aneurysm Completely Obstructing Lower End of Aqueduct of Sylvius , Arch. Neurol. & Psychiat. 40:1241-1243 ( (Dec.) ) 1938. 6. Trelles, J. O.; Suarez, L., and Mendez, M.: Un caso anatomo-clínico de síndrome de Benedikt , Rev. neuro-psiquiat. 1:51-84, 1938 7. Arch. latino. de neurol. 1:112-114, 1940 8. Institute of Living Series 8, no. 110, 1940. 9. Naffziger, H. C.: Brain Surgery, with Special Reference to Exposure of the Brain Stem and Posterior Fossa: The Principle of Intracranial Decompression and the Relief of Impactions of the Posterior Fossa , Surg., & Obst. 46:241-248 ( (Feb.) ) 1928. 10. Manufactured by Pilling & Company, Philadelphia. 11. Bailey, P.: Concerning the Technic of Operations for Acoustic Neurinoma , Zentralbl. f. Neurochir. 4:1-5 ( (Jan.) ) 1939. 12. Horrax, G.: Extirpation of a Huge Pinealoma from a Patient with Pubertas Praecox: A New Operative Approach , Arch. Neurol. & Psychiat. 37:385-397 ( (Feb.) ) 1937.

Journal

Archives of Neurology & PsychiatryAmerican Medical Association

Published: Jun 1, 1949

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