{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T19:44:09Z","timestamp":1792352649272,"version":"4.4.0"},"reference-count":15,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2014,10]]},"abstract":"<jats:p>Traumatic brain injuries afflict a large number of pediatric patients. The most severe injuries lead to increased intracranial pressure and herniation, with resultant changes in the brainstem. Traumatic brainstem hemorrhages have previously been associated with poor neurological outcome and fatality. However, this report discusses 2 pediatric patients who sustained severe head trauma with subsequent brainstem hemorrhages, and yet experienced good neurological outcome; the possible mechanism is described.<\/jats:p>","DOI":"10.3171\/2014.7.peds13376","type":"journal-article","created":{"date-parts":[[2014,10,1]],"date-time":"2014-10-01T08:42:59Z","timestamp":1412152979000},"page":"421-424","source":"Crossref","is-referenced-by-count":13,"title":["Pediatric brainstem hemorrhages after traumatic brain injury"],"prefix":"10.3171","volume":"14","author":[{"given":"Alexandra D.","family":"Beier","sequence":"first","affiliation":[{"name":"Division of Pediatric Neurological Surgery, University of Florida Health Jacksonville, Florida; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter B.","family":"Dirks","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, Hospital for Sick Children, University of Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"3 Suppl","key":"b1-peds13376","series-title":"Neurosurgery","first-page":"S16","article-title":"Surgical management of acute subdural hematomas","volume":"58","author":"Bullock","year":"2006"},{"key":"b2-peds13376","series-title":"Ann Neurol","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1002\/ana.410010613","article-title":"Survival with permanent midbrain dysfunction after surgical treatment of traumatic subdural hematoma: the clinical picture of a Duret hemorrhage?","volume":"1","author":"Caplan","year":"1977"},{"key":"b3-peds13376","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"52","DOI":"10.3171\/jns.1952.9.1.0052","article-title":"Recovery from the decerebrate state associated with supratentorial space-taking lesions","volume":"9","author":"Freedman","year":"1952"},{"key":"b4-peds13376","series-title":"Neurol Med Chir (Tokyo)","doi-asserted-by":"publisher","first-page":"508","DOI":"10.2176\/nmc.40.508","article-title":"Recovery from Duret hemorrhage: a rare complication after craniotomy\u2014case report","volume":"40","author":"Fujimoto","year":"2000"},{"key":"b5-peds13376","series-title":"Neurosurg Rev","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1007\/BF00383839","article-title":"Primary brain stem lesions caused by closed head injuries","volume":"16","author":"Hashimoto","year":"1993"},{"key":"b6-peds13376","series-title":"Pediatr Neurosurg","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1159\/000329624","article-title":"Decompressive hemicraniectomy for pediatric traumatic brain injury: long-term outcome based on quality of life","volume":"47","author":"Jacob","year":"2011"},{"issue":"4 Suppl","key":"b7-peds13376","series-title":"J Neurosurg","first-page":"268","article-title":"Outcome following decompressive craniectomy in children with severe traumatic brain injury: a 10-year single-center experience with long-term follow up","volume":"106","author":"Jagannathan","year":"2007"},{"key":"b8-peds13376","series-title":"Am J Emerg Med","doi-asserted-by":"publisher","first-page":"908","DOI":"10.1016\/j.ajem.2005.07.014","article-title":"Duret hemorrhage is not always suggestive of poor prognosis: a case of acute severe hyponatremia","volume":"23","author":"Kamijo","year":"2005"},{"key":"b9-peds13376","series-title":"Am J Pathol","first-page":"525","article-title":"The pathogenesis of secondary brainstem hemorrhages as studied in an experimental model","volume":"47","author":"Klintworth","year":"1965"},{"key":"b10-peds13376","series-title":"J Clin Neurosci","doi-asserted-by":"publisher","first-page":"1293","DOI":"10.1016\/j.jocn.2012.01.014","article-title":"Brainstem hemorrhage following decompressive craniectomy","volume":"19","author":"Lonjaret","year":"2012"},{"key":"b11-peds13376","series-title":"Intensive Care Med","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1007\/s00134-001-1160-y","article-title":"Brainstem hemorrhage in descending transtentorial herniation (Duret hemorrhage)","volume":"28","author":"Parizel","year":"2002"},{"key":"b12-peds13376","series-title":"Neurol Med Chir (Tokyo)","doi-asserted-by":"publisher","first-page":"594","DOI":"10.2176\/nmc.49.594","article-title":"Brain stem hemorrhage following burr hole drainage for chronic subdural hematoma\u2014case report","volume":"49","author":"Park","year":"2009"},{"key":"b13-peds13376","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1242","DOI":"10.3171\/2008.8.JNS08314","article-title":"Survival with good outcome after cerebral herniation and Duret hemorrhage caused by traumatic brain injury. 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