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A Study of Primary Cerebellar and Pontine Hemorrhages With Observations on Their Pathogenesis

HENRY B. DINSDALE, MD

Arch Neurol. 1964;10(2):200-217.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

Hypertension is the usual cause for primary hemorrhage into the pons or cerebellum in the absence of trauma or of displacement of vessels by pressure from above. Less frequently these hemorrhages accompany a bleeding disorder or a vascular malformation. Their incidence is greater than is generally appreciated, accounting for one fifth of all spontaneous intracerebral hemorrhages.^1,2 This figure may reflect only the relative volume and vascularity of these structures in comparison with the cerebral hemispheres.

Cheyne's report in 1812³ is the first adequate clinical description of primary pontine hemorrhage. Hillairet in 1858⁴ provided a lengthy account of cerebellar hemorrhage but came to the erroneous conclusion that symptoms of cerebellar disease were found on the side of the body opposite to the damaged hemisphere. The perceptive descriptions at the turn of the century by Gowers⁵ and Oppenheim⁶ delineated some of the more important clinical aspects of . . . [Full Text PDF of this Article]

Author Affiliations
BOSTON

From the Neurological Unit, Boston City Hospital, and the Department of Neurology, Harvard Medical School.

Present address: Department of Medicine, Queen's University, Kingston, Ont, Canada.

Footnotes
Submitted for publication July 17, 1963; accepted Oct 18.

An investigation conducted during tenure of an R. Samuel McLaughlin Travelling Fellowship in Medicine (Canada), and aided by a grant from the National Institutes of Health, Washington, NB 03477-02.

"Primary intracerebral hemorrhage" excluded those hemorrhages associated with trauma and also the secondary Duret hemorrhages due to sudden increase in intracranial pressure. It was decided to follow Dorothy Russell's classification10 and include only those hemorrhages in the pons with a diameter of 1.5 cm or greater and 3.0 cm or larger in the cerebellum. In fact, when traumatic and Duret hemorrhages were excluded, none smaller than these limits was found.

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