Successful stereotaxic evacuation of an acute pontomedullary hematoma

Case report

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✓ A healthy young woman developed a rapidly progressive pontomedullary lesion 24 hours after delivery of her first child. The lesion was shown on computerized tomography (CT) to be a primary hematoma. Stereotaxic aspiration was carried out, and the patient recovered. Angiography and CT scanning demonstrated a vascular lesion compatible with an arteriovenous malformation.

Article Information

Address reprint requests to: D. Andries Bosch, M.D., Department of Neurosurgery, St. Elisabeth Hospital, Tilburg, The Netherlands.

© AANS, except where prohibited by US copyright law.

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Figures

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    Left: Computerized tomography scan demonstrating a hyperdense lesion in the left pontomedullary junction, suggestive of a primary hematoma. Right: Vertebral arteriogram revealing bleeding from a perforating branch of the left posterior inferior cerebellar artery.

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    Left: Control x-ray film showing the tip of the stereotaxic puncture needle inside the hematoma. Right: Evacuation of blood by aspiration via the needle mounted on the Leksell stereotaxic apparatus.

  • View in gallery

    Computerized tomography scan 1 hour after surgery demonstrating air at the target area. There is no blood visible.

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