Clinical Research On Pontine Hemorrhage

More and more cases of primary pontine hemorrhage are found with development of CT. Twenty-three cases of pontine hemorrhage confirmed by CT or MRI and eight cases by autopsy are studied on etiology, clinical features, hematoma, the stress blood glucose concentration, position of hemorrhage, prognosis and pathology in the paper.Hypertension is the main cause of pontine hemorrhage. The symptoms are characterized by ocular abnormal signs, many kinds of limb dyskinesia and sensory disturbances of face and hemi-lateral body. Pontine hemorrhages are mostly located in the tegmentum. The tegmental hematomas are usually smaller, associated with cranial nerve lesions, less severe neurological deficits, and better prognosis. Because of the larger size of hematoma, most patients with hyperthermia, irregular respiration, gastro-intestinal bleeding, pinpoint pupil and quadriplegia at the onset. The prognosis of this type of patients is worst. The amount of the basal hemorrhage is between amount of the tegmental hemorrhage and that of the basotegmental hemorrhage. The basal hemorrhage has classic clinical of pontine hematoma hemorrhage and worse outcome. Extrapontine extension of is correlated with a poor prognosis. The patients with hematoma less than 2 cm in diameter and 6 ml in size have a good prognosis. In contrast, the patients with hematoma more than 2 cm in diameter and 6 ml in size have a poor outcome. The prognosis of hemorrhagic lacunar syndrome is best. In the acute stage of pontine hemorrhage, stress blood glucose concentration of patients with hematomas in base and basotegmentum is higher than that in tegmentum. The larger size of hematoma is found, the higher the blood glucose concentration. There is negative correlation between the severity of neurological deficit and blood glucose concentration. The death group has higher blood glucose level than the survival group. Mortality rate of hyperglycemia group is higher than that of the normal blood glucose group. Administration of insulin are recommended in the treatment at acute stage of pontine hemorrhage.Increasing of stress blood sugar was related with the prognosis of the pontine hemorrhage. And the concentration of the acute stress blood sugar was higher, then the state of the hemorrhage was more intensive and the mortality was higher.