Benign brainstem hemorrhage.

Most patients with brainstem hemorrhage have a poor prognosis. There are occasional reports of a favorable outcome with hematomas restricted to the mid-brain region. We report two patients with hematomas within the lower brainstem (pons and medulla) who made a good recovery. Diagnosis was unsuspected until the cranial CT scan was done. Angiography was normal in both cases. Recovery was excellent in one and fair in the second patient. Patients with medullary hemorrhage are at risk for aspiration and may suddenly develop respiratory arrest and therefore should be carefully observed. Our review of the literature suggests that with some small brain-stem hemorrhages recovery is good to excellent and recurrences are rare.