Pontine haematoma: Successful removal of two cases with review of 22 cases previously described in accessible literature

Abstract

Two cases of operative evacuation of pontine haematomas are described in addition to 22 cases reported in the literature. Clinical and neuroradiological findings indicate a brain stem lesion sometimes considered as an inoperable brain stem glioma. Computer assisted tomography todate easily reveals such hematomas. Successful operative results are generally obtained. This diagnosis must be considered when the onset of symptoms is progressive and young people are affected. We describe two young patients with rapidly progressive symptoms. In one case (case 2) the symptoms started after a bee sting but we were unable to find any real correlation. Surgical removal of blood clot was followed by progressive improvement in the patients who were able to return to normal active life.

Thalamic and Mesencephalic Hemorrhages after Multiple Honeybee Stings: A Life-Threatening Apitherapy Complication

“…The most common neurological manifestations of bee's venom poisoning is optic neuritis, other manifestations are rare and include brachial plexus block, exacerbation of multiple sclerosis, pontine hematoma, hypoxic brain injury with motor apraxia, encephalomyelopolyradiculoneuritis and hemorrhagic vasculitis [7][8][9][10]. This is the first report of a bilateral thalamic and mesencephalic hemorrhage secondary to bee's venom as a complication of apitherapy.…”

Successful stereotaxic evacuation of an acute pontomedullary hematoma

“…6,~~ With conservative treatment, the mortality rate is high in patients with primary pontine hematomas: 76 % of 25 cases has been reported in one series ~7 and 80% of 15 cases in another. 4 An 80% recovery rate has been achieved with surgical treatment, according to the review of Mattos Pimenta, et al, 12 who described 24 surgical patients.…”