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Surgery General 01a0317d

All of the following are true about Duret hemorrhage, EXCEPT:

A
Seen in conjunctiva
B
ICT increase
C
Cushing's triad
D
Seen in brain
High-Yield Explanation
Duret haemorrhage: "Progressive rise in ICP cause fuher downward herniation into the foramen magnum or coning. This result in shearing of perforators supplying the brain stem causing haemorrhage known as duret haemorrhage. Tractional damage to pituitary stalk can result in diabetes insipidus. With progressive herniation the pupils become midsize & non reacting. These are invariably irreversible events leading to brainstem death". In case of increased ICP downward herniation of brainstem occur, which cause stretching of perforators of basilar aery & may results in bleed (duret haemorrhage). The local syndrome may include cushing's triad (aerial hypeension, bradycardia & respiratory irregularity). Duret haemorrhage is small area of bleeding in ventral & paramedian pa of upper brainstem (midbrain and pons). It usually indicates a fatal outcome, however survival has been repoed. Diagnosis is made on CT or MRI". Ref: Love & Bailey, 24th Edition, Page 611; Operative Neurological Techniques by Henry, 5th Edition, Page 35

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