Duret Hemorrhages

Duret hemorrhages (also known as subependymal hemorrhages) are a special type of intracranial hemorrhage. They occur as a result of a rapid increase in intracranial pressure, which leads to rupture of small vessels located along the walls of the ventricles of the brain under the ependyma.

The cause of a sharp increase in intracranial pressure is most often severe traumatic brain injury. In this case, a displacement of brain structures occurs, which leads to stretching and rupture of subependymal vessels.

Duret hemorrhages have a characteristic localization along the ventricles of the brain and are often accompanied by disturbances of consciousness, focal neurological symptoms and autonomic disorders.

Diagnosis of dure hemorrhages is based on CT or MRI data of the brain. Treatment is aimed at combating cerebral edema and intracranial hypertension. The prognosis for dura hemorrhages is serious due to the high risk of brain herniation and death.

Duret hemorrhage is a rare pathological process characterized by bleeding between the pia mater and the wall of the ventricles of the brain. It is one of the rarest forms of hemorrhages in the ventricles of the brain, except for the rare situation when there is a hematoma due to a rupture of the ventricular wall. In this article we will consider in detail Duret hemorrhage. What is it and how to diagnose the disease? So, who is Duret and what diseases does he treat?

Who is Duret In the mid-19th century, the English physician Thomas Addison described a very rare syndrome of intracranial hemorrhage, causing difficulty breathing and leading to paralysis. This phenomenon was named after him and became known as Dyre hemorrhage. Bleeding in the syndrome is caused by the leakage of plasma from the loose walls of the subependymal space of the brain through the arachnoid membrane. Some time after its discovery, this pathology disappeared and remained only in rare medical encyclopedias. This syndrome is currently quite little known even to doctors, and the treatment prescribed 170 years ago looks absolutely archaic and has little effectiveness. Modern medicine knows nothing about Duret hemorrhage as a separate phenomenon; there is massive intracerebral hemorrhage with damage to the walls of the interventricular foramina. There are two reasons that explain the disappearance of the pathological process in medicine: the development of brain surgery and the study of the structure of the skull in the dissecting room. The latest study was considered boring because it did not contain interesting facts. We can only note the most striking variants of traumatic hemorrhages, the characteristic clinical picture and the morphological picture of the changes that have occurred. Duret Syndrome is currently diagnosed only in pediatricians. This may be due to the strangeness of the syndrome itself and the need for complex blood tests. But still, from old memory, this hemorrhage will be called Duret syndrome due to the fact that the process has not left medical practice, but has not received adequate coverage in popular scientific publications.

According to modern data, Duret syndrome does not exist. The real syndrome manifests itself in a completely different scenario. The main cause of hemorrhage into the cavity of the ventricle of the brain is sinus thrombosis, less commonly arterial aneurysms. This disease is one of the types of cerebrovascular complications. Small hemorrhages are most common. If we talk about hemorrhagic strokes affecting the basal parts of both hemispheres, then the probability of encountering hemorrhage in one of the hemispheres exceeds the probability of injury to the base of the brain. Large hematomas located in the temporal region rarely lead to hemorrhage into the ventricles of the brain according to Duret or other variants. Single hemorrhages do not lead to the development of the syndrome and are a manifestation of other brain diseases, such as intracranial tumors. Rathke's pouch cyst can also lead to Duret's signs with hemorrhages in the ventricles. Duret's diagnosis is made very rarely and is more like an exclusion diagnosis for gastrointestinal obstruction, arterial hyper