A 40-year-old male experienced several episodes of vomiting with progressing paralysis. A CT scan showed the presence of a 9.8 ml pontine hematoma (PH). The patient became comatose approximately 2 hours after onset. Pending three days of conservative treatment to manage hemostasis and pre-existing high blood pressure, the patient underwent 3D CT reconstruction-guided stereotactic aspiration of 6.8 ml of dark clotted blood. The patient regained consciousness approximately 3 weeks later and a follow-up CT scan showed that the remains of the hemorrhage (approximately 3.0 ml) were completely absorbed. After hyperbaric oxygen treatment and rehabilitation therapy, the patient recovered from the episode albeit with limited speech and the ability to walk with the use of rehabilitation equipment. The use of 3D CT reconstruction imaging is extremely helpful in pinpointing the exact location as well as accurately calculating the volume of a brainstem hemorrhage. These data are critical for neurosurgeons in deciding whether a patient is a good candidate for evacuation of the hemorrhage via stereotactic aspiration. To the best of our knowledge, this is the first report in the English-language literature of a three-dimensional CT reconstruction-guided stereotactic aspiration of PH.
[1]Jilin Univ, China Japan Union Hosp, Dept Neurosurg, 126 Xiantai St, Changchun 130033, Jilin, Peoples R China.
[2]Jilin Univ, Hosp 1, Dept Neurol, Changchun, Jilin, Peoples R China.
[3]Jilin Univ, Hosp 1, Dept Intervent Therapy, Changchun, Jilin, Peoples R China.
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