Duret Brainstem Hemorrhage Secondary to Large Supratentorial Meningioma

Abstract

A 75-year-old female patient was admitted following head trauma responsible for an acute-onset neurological worsening with a Glasgow Coma Scalescore of 6. Computed tomography scan revealed a large bifrontal meningioma with extralesional bleeding causing cranio-caudal transtentorial brain herniation. Despite emergency surgical excision of the tumor using craniotomy, the patient remained comatose. The brain magnetic resonance imaging revealed a Duret brainstem hemorrhage of the upper and middle pons, associated with supratentorial decompression-related brain injuries. One month later, the patient was withdrawn from life support. To our knowledge, tumor-induced Duret brainstem hemorrhage has never been reported.