Thursday, June 19, 2008

32 - duret hemorrhage - PGI chandigarh june 2008 mcqs

Q.1Duret haemorrhage found in?
a] lungs
b]kidney
c] endocardium of heart
d]Brain

ans is d]Brain
Duret haemorrhages (also spelled, Duret hemorrhages) are small areas of bleeding in the ventral and paramedian parts of the upper brainstem, (midbrain and pons). They are secondary to raised intracranial pressure with formation of a transtentorial pressure cone involving the cerebral peduncles (crus cerebri) and other midbrain structures caused by raised pressure above the tentorium. Kernohan’s notch is a groove in the cerebral peduncle that may be caused by this displacement of the brainstem against the incisura of the tentorium. The resulting ipsilateral hemiparesis is a false localising sign (Collier 1904), known as the Kernohan-Woltman syndrome. This may succeed or accompany temporal lobe (uncal) herniation and subfalcian herniation secondary to a supratentorial mass.

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