Ying Huang*, Han Luo**, Qianhui Xu*, Qian Wang*, Xuejun Fu*, Xiaofan Chu*, ***, #


*Department of Neurology, The First Affiliated Hospital of Southern University of Science and Technology, The Second Clinical Medical College of Jinan University, Shenzhen People’s Hospital, Shenzhen, PR China - **Department of Neurology, Shenzhen Longhua District Central Hospital, Shenzhen, PR China - ***Department of Neurology, the University of Hong Kong-Shenzhen Hospital, Shenzhen, PR China


Little is known about secondary brainstem haemorrhage which has no morphological relationship to primary cerebral haemorrhage in patients. In this study of 230 consecutive autopsy cases with primary cerebral haemorrhage, secondary brainstem haemorrhage cases were selected according to the following criteria: (1) there was a primary bleeding focus in the cerebral hemisphere; (2) gross appraisal revealed haemorrhage focus in the brainstem; and (3) morphologically, the haemorrhage focus in the brainstem was not related to the one in the cerebral hemisphere. A further observation and analysis of their shape and location was performed. Of the sample, 33 cases (14.3%) fulfilled the criteria of secondary brainstem haemorrhage. In these cases, secondary brainstem haemorrhage often occurred on the same side as the primary cerebral haemorrhage in the pons: the basal region, tegmental region, and the area around the fourth ventricle. The reason for the brainstem haemorrhage may have been the presence of active circulation in the damaged blood vessels of the displaced rostral brainstem. In conclusion, the frequency of secondary brainstem haemorrhage in the study was 14.3%, and it often occurred on the same side as the primary cerebral haemorrhage. It often appeared following primary intracerebral haemorrhage due to ruptured blood vessels in the brainstem, as a result of interaction between the brainstem and haematoma. 


Secondary brainstem haemorrhage, morphological, autopsy.