Hematoma primário do tronco cerebral: considerações a propósito de um caso

Salomão, J. Francisco; Vialogo, Josué G.; Lynch, José Carlos

doi:10.1590/S0004-282X1989000200012

Resumos

Os autores relatam o caso de hematoma primário do tronco cerebral em uma paciente de 48 anos, normotensa. A evolução arrastada do processo sugeria tumor de tronco, sendo o diagnóstico de hematoma estabelecido por exploração cirúrgica. Discute-se a origem desses hematomas, conseqüentes à ruptura de angiomas crípticos ou microangiomas, bem como o diagnóstico diferencial com hemorragias hipertensivas do tronco cerebral, patologia de prognóstico sombrio, na maioria das vezes sem indicação cirúrgica. Dão ênfase à necessidade da sistemática exploração das lesões expansivas do tronco cerebral, principalmente em se tratando de indivíduos jovens e normotensos.

The case of a 48 year-old woman present ng with a primary pontine hematoma is reported. The clinical evolution simulated a brain stem tumor and the diagnosis of hematoma was not established before the operation. The preoperative neurological deficit improved except for a facial nerve palsy. These hematomas are thought to be due to rupture of «cryptic» arteriovenous malformations and should be differentiated from those secondary to systemic hypertension. The diagnosis of brain stein hematomas should be considered in any case of brain stem lesion, especially in young and normotensive patients.

Hematoma primário do tronco cerebral: considerações a propósito de um caso

Primary brain stem hematoma - report of one case

J. Francisco Salomão; Josué G. Vialogo; José Carlos Lynch

Serviço de Neurocirurgia do Hospital dos Servidores do Estado (INAMPS), Rio de Janeiro

RESUMO

Os autores relatam o caso de hematoma primário do tronco cerebral em uma paciente de 48 anos, normotensa. A evolução arrastada do processo sugeria tumor de tronco, sendo o diagnóstico de hematoma estabelecido por exploração cirúrgica. Discute-se a origem desses hematomas, conseqüentes à ruptura de angiomas crípticos ou microangiomas, bem como o diagnóstico diferencial com hemorragias hipertensivas do tronco cerebral, patologia de prognóstico sombrio, na maioria das vezes sem indicação cirúrgica. Dão ênfase à necessidade da sistemática exploração das lesões expansivas do tronco cerebral, principalmente em se tratando de indivíduos jovens e normotensos.

SUMMARY

The case of a 48 year-old woman present ng with a primary pontine hematoma is reported. The clinical evolution simulated a brain stem tumor and the diagnosis of hematoma was not established before the operation. The preoperative neurological deficit improved except for a facial nerve palsy. These hematomas are thought to be due to rupture of «cryptic» arteriovenous malformations and should be differentiated from those secondary to systemic hypertension. The diagnosis of brain stein hematomas should be considered in any case of brain stem lesion, especially in young and normotensive patients.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Av. N. S. Copacabana, 1018/608 - 22060 Rio de Janeiro RJ - Brasil

1. Abroms IF, Yessayan L, Shilito J Jr, Barlow CF - Spontaneous intracerebral haemorrhage in patients suspected of multiple sclerosis. J Neurol Neurosurg Psychiat 34: 157, 1971.
2. Albright AL, Byrd RP, Harrison ML - Angiographically cryptic AVM presenting as a pontine tumor: case report. J Neurosurg 53: 846, 1980.
3. Arseni C, Gontea A - Hemorrhage and hematoma. In Pia HW, Langmaid C, Zierski J (eds): Spontaneous Intracerebral Hematoma. Advances in Dianosis and Therapy. Springer, Berlin, 1980, pg 301.
4. Arseni C, Gontea A - Indications and contra-indications for operation in primary hematomas of the cerebellum and brain stem. In Pia HW, Langmaid C, Zierski J (eds): Spontaneous Intracerebral Hematoma. Advances in Diagnosis and Therapy. Springer, Berlin, 1980, pg 357.
5. Arseni C, Stanciu M - Primary haematomas of the brain stem. Acta Neurochir 28: 323, 1973.
6. Becker DH, Silverberg GD - Successful evacuation of an acute pontine hematoma. Surg Neurol 10:263, 1978.
7. Bell BA, Kendall BE, Symon L - Angiographically occult arteriovenous malformations of the brain. J Neurol Neurosurg Psychiatr 11: 1057, 1978.
8. Bock WJ, Sprick C - Neurosurgical advances relating to pontine hemorrhages. In: Sami M (ed): Surgery in and Arrcund the Brain Stem and the Third Ventricle. Springer, Berlin, 1986, pg 297.
9. Bosch DA, Beute GN - Successful stereotaxic evacuation of an acute pontomedullary hematoma: case report. J Neurosurg 62: 153, 1985.
10. Burns J, Lisak R, Schut L, Silverberg D - Recovery following brainstem hemorrhage. Ann Neurol 7:183, 1978.
11. Caplan LR, Goodwin JA - Lateral tegmental brain stem hemorrhages. Neurology 32: 258, 1982.
12. Ciminello VJ, Sachs E Jr - Arteriovenous malformations of the posterior fossa. J Neurosurg 19: 602, 1962.
13. Collomb H, Dumas M, Girard PL, Lemercier G, Tap D - Hémorragies primitives du tronc cérébral: étude anatomique et clinique de 36 cas. Rev Neurol (Paris) 129: 185, 1973.
14. Crawford JV, Russell DS - Cryptic arteriovenous and venous hamartomas of the brain. J Neurol Neurosurg Psychiat 19: 1, 1956.
15. Dandy WE - The brain. In Lewis D (ed): The Practice of Surgery, Vol 12. WF Parson Co, Hagerstown, 1957, pg 613.
16. Diamond C, Torvick A, Amundsen P - Angiografic diagnosis of teleangiectasies with cavernous angioma of the posterior fossa: report of two cases. Acta Radiol (Diag) 17: 281, 1976.
17. Doczi T, Thomas GT - Successful removal of an intrapontine haematoma. J Neurol Neurosurg Psychiat 42: 1058, 1979.
18. Durward QJ, Barnett JM, Barr HWK - Presentation and management of mesencephalic hematoma: report of two cases. J Neurosurg 56: 123, 1982.
19. Gerlach J - Intracerebral hemorrhage caused by microangioma. In Krayenbuhl H, Maspes P, Sweet WH (eds): Progress in Neurological Surgery. Vol 2. Karger, Basel, 1968, pg 312.
20. Golden JB, Kramer RA - The angiographically occult cerebrovascular malformation: report of three cases. J Neurosurg 48: 292, 1978.
21. Gros C, Giraud G, Latour H - Hematome spontané de la calotte protubérantielle opéré et guéri. Presse Med 73: 890, 1948.
22. Humphreys RP - Computerized tomographic definition of mesencephalic hematoma with evacuation through pedunculotomy: case report. J Neurosurg 49: 749, 1978.
23. Inoue Y, Sato O - Succesful removal of pontine haematoma due to rupture of cryptic arteriovenous malformation: case report. Acta Neurochir 69: 69, 1983.
24. Kempe LG - Surgical removal of an intramedullary haematoma simulating Wallemberg's syndrome. J Neurol Neurosurg Psychiat 27: 78, 1964.
25. Koos WT, Sunder-Plassmann M, Salah S - Successful removal of a large intrapontine hematoma: case report. J Neurosurg 31: 690, 1969.
26. Kowada M, Ito Z, Matsuoka S, Yamaguchi K - Primary pontine hemorrhage revealed by pneumoencephalo-roullete tomography, and a report on surgically treated cases. Acta Neurochir 25: 269, 1971.
27. Kramer RA, Wing SD - Computed tomography of angiographically occult cerebral vascular malformations. Radiology 123: 649, 1977.
28. LaTorre E, Delitala A, Sorano V - Hematoma of the quadrigeminal plate: case report. J Neurosurg 49: 610, 1978.
29. Lessell S, Ferris EJ, Feldman RG, Hoyt WF - Brain stem arteriovenous malformations. Arch Ophtalm 86: 255, 1971.
30. Lindheimer JH, Barrows HS - Recurrent pontine hemorrhagic incident to venous angioma of the pons: report of case. Bull Los Angeles Neurol Soc 27: 128, 1962.
31. Margolis G, Odom GL, Woodhall B, Bloor BM - The role os small angiomatous malformations in the production of intracerebral hematoma. J Neurosurg 8: 564, 1952.
32. Martin P, Noterman J - L'hématome bulboprotubérantiel opérable. Acta Neurol Belg 71: 261, 1971.
33. Mattos Pimenta LH, Mattos Pimenta A, Zuckermann E - Pontine hematoma: successful removal of two cases with review of 22 cases previously described in the accessible literature. Neurosurg Rev 4: 139, 1981.
34. McCormick WF, Hardman JM, Boulter TR - Vascular malformations (angiomas) of the brain with special reference to those occurring in the posterior fossa. J Neurosurg 28: 241, 1968.
35. McCormick WF, Nofzinger JD - «Cryptic» vascular malformations of the central nervous system. J Neurosurg 24: 865, 1966.
36. Mc Lean AJ - In Bumke O, Foerster O - Handbuch der Neurologic Vol 14. Springer, Berlin, 1936, pg 201.
37. Michael JC, Levin PM - Multiple telangiectasies of the brain. Arch Neurol Psychiatr 36: 514, 1936.
38. Obrador S, Dierssen G, Odoriz BJ - Surgical evacuation of pontine-medullary hematoma. J Neurosurg 33: 82, 1970.
39. Ojemann GR, Heros RC - Spontaneous brain hemorrhage. Stroke 11: 468, 1983.
40. Okudera T, Chida T, Uemura K, Takita K, Yamaguchi K - «Cryptic» arteriovenous malformations in the pons: a case report. Mount Sinai J Med 45: 86, 1978.
41. O'Laoire SA, Crockard HA, Thomas DG, Gordon DS - Brain stem hematoma: a report of six surgically treated cases. J Neurosurg 56: 222, 1982.
42. Pak H, Patel SC, Malik GM, Ausman JI - Successful evacuation of a pontine hematoma secondary to rupture of a venous angioma. Surg Neurol 15: 164, 1981.
43. Papo I, Pasquim U, Salvolini TJ - Subependymal brain stem hematomas: a report of two cases. Neuroradiology 11: 279, 1976.
44. Pau A, Viale ES, Turtas S - Surgical removal of a pontine haematoma associated with a cryptic angioma: case report. Acta Neurochir 50: 299, 1979.
45. Payne HA, Maravilla KR, Levinstone A, Heuter J, Tindall RSA - Recovery from primary pontine hemorrhage. Ann Neurol 14: 557, 1978.
46. Pouyanne H, Got M, Julien J, Riemens V, Paoli M - Deux cas d'hématomes intra-protubérantiels opérés: étude critique. Neurochirurgie 13: 738, 1967.
47. Roberson GH, Kase CS, Wolpow - Telangiectases and cavernous angiomas of the brain stem: «cryptic» vascular malformations: report of a case. Neuroradiology 8: 83, 1974.
48. Russell B, Rengachary S, McGregor D - Primary pontine hematoma presenting as a cerebellopontine angle mass. Neurosurgery 19: 129, 1986.
49. Russell DS - The pathology of spontaneous intracranial hemorrhages. Proc Roy Soc Med 47: 689, 1954.
50. Russo RH, Dicks RE III - Arteriovenous malformations of the brain stem in childhood. Surg Neurol 8: 167, 1977.
51. Sano K, Ochiai C - Brain stem hematoma: clinical aspects with reference to indication for treatment. In Pia HW, Langmaid C, Zierski J (eds): Spontaneous intracerebral Hematoma. Advances in Diagnosis and Therapy. Springer, Berlin, 1980, pg 366.
52. Schaefer M, Richter HP, Klein HJ - Surgical removal of an intrapontine hematoma: case report. In Sami M (ed): Surgery in and Arround the Brain Stem. Springer, Berlin, 1986, pg 302.
53. Scoville WB, Poppen JL - Intrapeduncular hemorrhage of the brain: succesful operative approach with evacuation of a clot and a seven and one-forth year observation period. Arch Neurol Neurosurg Psychiatr 61: 688, 1949.
54. Scott BB, Seeger JF, Schneider RC - Successfull evacuation of a pontine hematoma secondary to rupture of a pathologically diagnosed cryptic vascular malformation: case report. J Neurosurg 39: 104, 1973.
55. Shuey HMJr, Day AL, Quisling RG, Sypert GW - Angiographically cryptic cerebrovascular malformations. Neurosurgery 5: 476, 1979.
56. Silverstein A - Primary pontine hemorrhage: review of 50 cases. Confinia Neurol 29: 33, 1967.
57. Sthal SM, Johnson KP, Malamud N - The clinical and pathological spectrum of brain stem vascular malformations: long term course simulating multiple sclerosis. Arch Neurol 37: 25, 1980.
58. Teilmann K - Hemangiomas of the pons. Arch Neurol Psychiatr 69: 208, 1953.
59. Tenuto R, Cruz OR - Hematoma intraprotuberancial. Arq Neuro-Psiquiatr (São Paulo) 16: 201, 1958.
60. Terao H, Hori T, Matsutani M, Okeda R - Detection of cryptic vascular malformations by CT: report of two cases. J Neurosurg 51: 546, 1979.
61. Texier P, Diebler C, Bruguier A, Ponsot G - Hematoma of the brain stem in childhood. Neuroradiology 26: 499, 1984.
62. Vaquero J, Areitio E, Leunda G, Bravo G - Hematomas of the pons. Surg Neurol 14: 115, 1980.
63. Veerapen RJ, Sbeih IA, O'Laoire SA - Surgical treatment of cryptic AVMs and associated hematoma in the brain stem and spinal cord. J Neurosurg 65:188, 1986.
64. White RJ, Wood N, Kernohan JW - Study of 50 intracranial vascular tumors found incidentally at necropsy. J Neuropath Exp Neurol 17: 392, 1958.
65. Yates A, Enzmann D - Cryptic vascular malformations involving the brain stem. Radiology 146: 71, 1983.
66. Zuccarello M, Iavicoli R, Pardatscher K, Scanarini M, Fiori D, Andrioli GC - Primary brain stem haematomas. Diagnosis and treatment. Acta Neurochir 54: 45, 1980.

Datas de Publicação

Publicação nesta coleção
06 Jun 2011
Data do Fascículo
Jun 1989

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Abroms IF, Yessayan L, Shilito J Jr, Barlow CF - Spontaneous intracerebral haemorrhage in patients suspected of multiple sclerosis. J Neurol Neurosurg Psychiat 34: 157, 1971.

[2] 2. Albright AL, Byrd RP, Harrison ML - Angiographically cryptic AVM presenting as a pontine tumor: case report. J Neurosurg 53: 846, 1980.

[3] 3. Arseni C, Gontea A - Hemorrhage and hematoma. In Pia HW, Langmaid C, Zierski J (eds): Spontaneous Intracerebral Hematoma. Advances in Dianosis and Therapy. Springer, Berlin, 1980, pg 301.

[4] 4. Arseni C, Gontea A - Indications and contra-indications for operation in primary hematomas of the cerebellum and brain stem. In Pia HW, Langmaid C, Zierski J (eds): Spontaneous Intracerebral Hematoma. Advances in Diagnosis and Therapy. Springer, Berlin, 1980, pg 357.

[5] 5. Arseni C, Stanciu M - Primary haematomas of the brain stem. Acta Neurochir 28: 323, 1973.

[6] 6. Becker DH, Silverberg GD - Successful evacuation of an acute pontine hematoma. Surg Neurol 10:263, 1978.

[7] 7. Bell BA, Kendall BE, Symon L - Angiographically occult arteriovenous malformations of the brain. J Neurol Neurosurg Psychiatr 11: 1057, 1978.

[8] 8. Bock WJ, Sprick C - Neurosurgical advances relating to pontine hemorrhages. In: Sami M (ed): Surgery in and Arrcund the Brain Stem and the Third Ventricle. Springer, Berlin, 1986, pg 297.

[9] 9. Bosch DA, Beute GN - Successful stereotaxic evacuation of an acute pontomedullary hematoma: case report. J Neurosurg 62: 153, 1985.

[10] 10. Burns J, Lisak R, Schut L, Silverberg D - Recovery following brainstem hemorrhage. Ann Neurol 7:183, 1978.

[11] 11. Caplan LR, Goodwin JA - Lateral tegmental brain stem hemorrhages. Neurology 32: 258, 1982.

[12] 12. Ciminello VJ, Sachs E Jr - Arteriovenous malformations of the posterior fossa. J Neurosurg 19: 602, 1962.

[13] 13. Collomb H, Dumas M, Girard PL, Lemercier G, Tap D - Hémorragies primitives du tronc cérébral: étude anatomique et clinique de 36 cas. Rev Neurol (Paris) 129: 185, 1973.

[14] 14. Crawford JV, Russell DS - Cryptic arteriovenous and venous hamartomas of the brain. J Neurol Neurosurg Psychiat 19: 1, 1956.

[15] 15. Dandy WE - The brain. In Lewis D (ed): The Practice of Surgery, Vol 12. WF Parson Co, Hagerstown, 1957, pg 613.

[16] 16. Diamond C, Torvick A, Amundsen P - Angiografic diagnosis of teleangiectasies with cavernous angioma of the posterior fossa: report of two cases. Acta Radiol (Diag) 17: 281, 1976.

[17] 17. Doczi T, Thomas GT - Successful removal of an intrapontine haematoma. J Neurol Neurosurg Psychiat 42: 1058, 1979.

[18] 18. Durward QJ, Barnett JM, Barr HWK - Presentation and management of mesencephalic hematoma: report of two cases. J Neurosurg 56: 123, 1982.

[19] 19. Gerlach J - Intracerebral hemorrhage caused by microangioma. In Krayenbuhl H, Maspes P, Sweet WH (eds): Progress in Neurological Surgery. Vol 2. Karger, Basel, 1968, pg 312.

[20] 20. Golden JB, Kramer RA - The angiographically occult cerebrovascular malformation: report of three cases. J Neurosurg 48: 292, 1978.

[21] 21. Gros C, Giraud G, Latour H - Hematome spontané de la calotte protubérantielle opéré et guéri. Presse Med 73: 890, 1948.

[22] 22. Humphreys RP - Computerized tomographic definition of mesencephalic hematoma with evacuation through pedunculotomy: case report. J Neurosurg 49: 749, 1978.

[23] 23. Inoue Y, Sato O - Succesful removal of pontine haematoma due to rupture of cryptic arteriovenous malformation: case report. Acta Neurochir 69: 69, 1983.

[24] 24. Kempe LG - Surgical removal of an intramedullary haematoma simulating Wallemberg's syndrome. J Neurol Neurosurg Psychiat 27: 78, 1964.

[25] 25. Koos WT, Sunder-Plassmann M, Salah S - Successful removal of a large intrapontine hematoma: case report. J Neurosurg 31: 690, 1969.

[26] 26. Kowada M, Ito Z, Matsuoka S, Yamaguchi K - Primary pontine hemorrhage revealed by pneumoencephalo-roullete tomography, and a report on surgically treated cases. Acta Neurochir 25: 269, 1971.

[27] 27. Kramer RA, Wing SD - Computed tomography of angiographically occult cerebral vascular malformations. Radiology 123: 649, 1977.

[28] 28. LaTorre E, Delitala A, Sorano V - Hematoma of the quadrigeminal plate: case report. J Neurosurg 49: 610, 1978.

[29] 29. Lessell S, Ferris EJ, Feldman RG, Hoyt WF - Brain stem arteriovenous malformations. Arch Ophtalm 86: 255, 1971.

[30] 30. Lindheimer JH, Barrows HS - Recurrent pontine hemorrhagic incident to venous angioma of the pons: report of case. Bull Los Angeles Neurol Soc 27: 128, 1962.

[31] 31. Margolis G, Odom GL, Woodhall B, Bloor BM - The role os small angiomatous malformations in the production of intracerebral hematoma. J Neurosurg 8: 564, 1952.

[32] 32. Martin P, Noterman J - L'hématome bulboprotubérantiel opérable. Acta Neurol Belg 71: 261, 1971.

[33] 33. Mattos Pimenta LH, Mattos Pimenta A, Zuckermann E - Pontine hematoma: successful removal of two cases with review of 22 cases previously described in the accessible literature. Neurosurg Rev 4: 139, 1981.

[34] 34. McCormick WF, Hardman JM, Boulter TR - Vascular malformations (angiomas) of the brain with special reference to those occurring in the posterior fossa. J Neurosurg 28: 241, 1968.

[35] 35. McCormick WF, Nofzinger JD - «Cryptic» vascular malformations of the central nervous system. J Neurosurg 24: 865, 1966.

[36] 36. Mc Lean AJ - In Bumke O, Foerster O - Handbuch der Neurologic Vol 14. Springer, Berlin, 1936, pg 201.

[37] 37. Michael JC, Levin PM - Multiple telangiectasies of the brain. Arch Neurol Psychiatr 36: 514, 1936.

[38] 38. Obrador S, Dierssen G, Odoriz BJ - Surgical evacuation of pontine-medullary hematoma. J Neurosurg 33: 82, 1970.

[39] 39. Ojemann GR, Heros RC - Spontaneous brain hemorrhage. Stroke 11: 468, 1983.

[40] 40. Okudera T, Chida T, Uemura K, Takita K, Yamaguchi K - «Cryptic» arteriovenous malformations in the pons: a case report. Mount Sinai J Med 45: 86, 1978.

[41] 41. O'Laoire SA, Crockard HA, Thomas DG, Gordon DS - Brain stem hematoma: a report of six surgically treated cases. J Neurosurg 56: 222, 1982.

[42] 42. Pak H, Patel SC, Malik GM, Ausman JI - Successful evacuation of a pontine hematoma secondary to rupture of a venous angioma. Surg Neurol 15: 164, 1981.

[43] 43. Papo I, Pasquim U, Salvolini TJ - Subependymal brain stem hematomas: a report of two cases. Neuroradiology 11: 279, 1976.

[44] 44. Pau A, Viale ES, Turtas S - Surgical removal of a pontine haematoma associated with a cryptic angioma: case report. Acta Neurochir 50: 299, 1979.

[45] 45. Payne HA, Maravilla KR, Levinstone A, Heuter J, Tindall RSA - Recovery from primary pontine hemorrhage. Ann Neurol 14: 557, 1978.

[46] 46. Pouyanne H, Got M, Julien J, Riemens V, Paoli M - Deux cas d'hématomes intra-protubérantiels opérés: étude critique. Neurochirurgie 13: 738, 1967.

[47] 47. Roberson GH, Kase CS, Wolpow - Telangiectases and cavernous angiomas of the brain stem: «cryptic» vascular malformations: report of a case. Neuroradiology 8: 83, 1974.

[48] 48. Russell B, Rengachary S, McGregor D - Primary pontine hematoma presenting as a cerebellopontine angle mass. Neurosurgery 19: 129, 1986.

[49] 49. Russell DS - The pathology of spontaneous intracranial hemorrhages. Proc Roy Soc Med 47: 689, 1954.

[50] 50. Russo RH, Dicks RE III - Arteriovenous malformations of the brain stem in childhood. Surg Neurol 8: 167, 1977.

[51] 51. Sano K, Ochiai C - Brain stem hematoma: clinical aspects with reference to indication for treatment. In Pia HW, Langmaid C, Zierski J (eds): Spontaneous intracerebral Hematoma. Advances in Diagnosis and Therapy. Springer, Berlin, 1980, pg 366.

[52] 52. Schaefer M, Richter HP, Klein HJ - Surgical removal of an intrapontine hematoma: case report. In Sami M (ed): Surgery in and Arround the Brain Stem. Springer, Berlin, 1986, pg 302.

[53] 53. Scoville WB, Poppen JL - Intrapeduncular hemorrhage of the brain: succesful operative approach with evacuation of a clot and a seven and one-forth year observation period. Arch Neurol Neurosurg Psychiatr 61: 688, 1949.

[54] 54. Scott BB, Seeger JF, Schneider RC - Successfull evacuation of a pontine hematoma secondary to rupture of a pathologically diagnosed cryptic vascular malformation: case report. J Neurosurg 39: 104, 1973.

[55] 55. Shuey HMJr, Day AL, Quisling RG, Sypert GW - Angiographically cryptic cerebrovascular malformations. Neurosurgery 5: 476, 1979.

[56] 56. Silverstein A - Primary pontine hemorrhage: review of 50 cases. Confinia Neurol 29: 33, 1967.

[57] 57. Sthal SM, Johnson KP, Malamud N - The clinical and pathological spectrum of brain stem vascular malformations: long term course simulating multiple sclerosis. Arch Neurol 37: 25, 1980.

[58] 58. Teilmann K - Hemangiomas of the pons. Arch Neurol Psychiatr 69: 208, 1953.

[59] 59. Tenuto R, Cruz OR - Hematoma intraprotuberancial. Arq Neuro-Psiquiatr (São Paulo) 16: 201, 1958.

[60] 60. Terao H, Hori T, Matsutani M, Okeda R - Detection of cryptic vascular malformations by CT: report of two cases. J Neurosurg 51: 546, 1979.

[61] 61. Texier P, Diebler C, Bruguier A, Ponsot G - Hematoma of the brain stem in childhood. Neuroradiology 26: 499, 1984.

[62] 62. Vaquero J, Areitio E, Leunda G, Bravo G - Hematomas of the pons. Surg Neurol 14: 115, 1980.

[63] 63. Veerapen RJ, Sbeih IA, O'Laoire SA - Surgical treatment of cryptic AVMs and associated hematoma in the brain stem and spinal cord. J Neurosurg 65:188, 1986.

[64] 64. White RJ, Wood N, Kernohan JW - Study of 50 intracranial vascular tumors found incidentally at necropsy. J Neuropath Exp Neurol 17: 392, 1958.

[65] 65. Yates A, Enzmann D - Cryptic vascular malformations involving the brain stem. Radiology 146: 71, 1983.

[66] 66. Zuccarello M, Iavicoli R, Pardatscher K, Scanarini M, Fiori D, Andrioli GC - Primary brain stem haematomas. Diagnosis and treatment. Acta Neurochir 54: 45, 1980.

Brasil

Brasil

Hematoma primário do tronco cerebral: considerações a propósito de um caso

Primary brain stem hematoma: report of one case

Resumos

Datas de Publicação