Duret haemorrhages are small linear areas of bleeding in the midbrain and upper pons of the brainstem. They are caused by a traumatic downward displacement of the brainstem.[1]
Duret haemorrhages are named after Henri Duret,[2] who discovered these brainstem lesions in dogs with increased intracranial pressure.[3] They are small linear areas of bleeding in the midbrain and upper pons of the brainstem.[citation needed]
Duret haemorrhages are haemorrhages secondary to raised intracranial pressure with formation of a transtentorial pressure cone involving the front part of the cerebral peduncles, the cerebral crura. Increased pressure above the tentorium may also involve other midbrain structures.[citation needed]
The pathophysiological mechanism is uncertain[7] but is probably caused by the displacement of the brainstem stretching and tearing perforating branches of the basilar artery to the pons; venous infarction may play a role.[citation needed]
George Gershwin died after emergency surgery of a large brain tumour, believed to have been a glioblastoma. The fact that he had suddenly collapsed and become comatose when he stood up on his last day of life, has been interpreted as brain herniation and Duret haemorrhages.[12]
^Dorland's (2012). Dorland's Illustrated Medical Dictionary (32nd ed.). Elsevier. p. 824. ISBN978-1-4160-6257-8.
^Collier, J. The false localizing signs of intracranial tumour. Brain 27:490-508, 1904.
^J. W. Kernohan JW, Woltman HW. Incisura of the crus due to contralateral brain tumor. Archives of Neurology and Psychiatry, Chicago, 1929, 21: 274–287.
^Parizel PM, Makkat S, Jorens PG, et al. (January 2002). "Brainstem hemorrhage in descending transtentorial herniation (Duret hemorrhage)". Intensive Care Med. 28 (1): 85–8. doi:10.1007/s00134-001-1160-y. PMID11819006. S2CID206883112.
^Fujimoto Y, Aguiar PH, Freitas AB, de Andrade AF, Marino Júnior R (October 2000). "Recovery from Duret hemorrhage: a rare complication after craniotomy--case report". Neurol. Med. Chir. (Tokyo). 40 (10): 508–10. doi:10.2176/nmc.40.508. PMID11098635.
^Kamijo Y, Soma K, Kishita R, Hamanaka S (November 2005). "Duret hemorrhage is not always suggestive of poor prognosis: a case of acute severe hyponatremia". Am J Emerg Med. 23 (7): 908–10. doi:10.1016/j.ajem.2005.07.014. PMID16291454.
