- Small multiple haemorrhages in the midbrain/pons due to transtentorial herniation
- They have a dismal prognosis.
- Mechanism
- Raised supratentorial pressure causes the brainstem and mesial temporal lobes to be forced downwards through the tentorial hiatus.
- As a result of this shift, it is believed that perforating branches from the basilar artery and/or draining veins are damaged with resultant parenchymal haemorrhage.
- Most commonly it is seen in patients with severe herniation 12 to 24 hours prior to death
- What is the difference between a Duret hemorrhage and brainstem small tissue-tear hemorrhages that accompany a DAI?
Both are located in the upper brainstem, but a Duret hemorrhage tends to be delayed and located in the paramedian areas, whereas DAI is typically located in the dorsolateral brainstem
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