Duret haemorrhage

Duret haemorrhages are small lineal areas of bleeding in the midbrain and upper pons of the brainstem. They are caused by a traumatic downward displacement of the brainstem.

They are named after Henri Duret.

Duret haemorrhages are named after Henri Duret who described them 1955. They are small lineal areas of bleeding in the midbrain and upper pons of the brainstem.

They are caused by a traumatic downward displacement of the brainstem with hippocampal gyrus herniation through the tentorial notch. or acute hematoma, edema following trauma, abscess, or tumor.

Duret haemorrhages are haemorrhages secondary to raised intracranial pressure with formation of a transtentorial pressure cone involving the front part of the cerebral peduncles, the cerebral crura. Increased pressure above the tentorium may also involve other midbrain structures.

Kernohan's notch is a groove in the cerebral peduncle which may be caused by this displacement of the brainstem against the tentorial incisure. The resulting ipsilateral hemiparesis is a false localising sign, 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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