Small hemorrhages in the brain stem. A sign of injury?

Microscopic hemorrhages in the brain stem were studied in cases of known head injury and in cases where head injury was known not to have occurred. They were found to be either strictly limited to the perivascular space or to extend into the neuropil. Those limited to the perivascular space appear to be artifacts and should not be considered when determining the cause of death. Extravasations of red cells into the neuropil may be of traumatic genesis. Such hemorrhages may be absent, however, in cases of a fatal primary brain-stem injury.