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January 1960

Pontine Hemorrhage Following Cranial Surgery for Supratentorial Tumor

Author Affiliations

From the Departments of Neurology, Jefferson Medical College and the Woman's Medical College of Pennsylvania.

AMA Arch Neurol. 1960;2(1):62-73. doi:10.1001/archneur.1960.03840070064007

Introduction  In a general study of pontine hemorrhage, four cases were observed in patients who had had operations for supratentorial tumors. Since pontine hemorrhages following such operations have not been sufficiently recognized, and in view of the fact that the causes of postoperative mortality following this type of surgery have not always been easily determined, this paper reports these cases and discusses the clinical and pathological features of such hemorrhages, and the possible mechanisms involved in their production.The causes of pontine hemorrhage have been extensively reviewed since Dana's1 report, in 1903. He listed many factors, including nephritis, alcoholism, syphilis, and secondary hemorrhage from tumors. Eight years later, Attwater2 observed that hemorrhages were secondary either to trauma or to apoplectic hemorrhages. In 1917 Greenacre3 differentiated nontraumatic and traumatic pontine hemorrhages, stating that the traumatic pontine lesions were frequently multiple and petechial in character, whereas nontraumatic

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