A Case of Traumatic Hematoma in the Basal Ganglia That Showed Deterioration After Arrival at the Hospital

Abstract

A case of traumatic hematoma in the basal ganglia that showed deterioration after arrival at the hospital was reported. A 65-year-old man crashed into the wall while riding a motorcycle. His Glasgow coma scale was E3V4M6 and showed retrograde amnesia and slight right motor weakness. Because head CT in the secondary trauma survey showed subarachnoid hemorrhage in the right Sylvian fissure and multiple gliding contusions in the left frontal and parietal lobe, he was entered into the intensive care unit for diagnosis of diffuse brain injury. He showed complete muscle weakness of left upper and lower limbs 5 h after the accident. Head CT newly showed hematoma, 2 cm in diameter, in the right basal ganglia. The patient vomited following the CT scan, and so his consciousness suddenly deteriorated into a stupor. We performed head CT again. The hematoma had enlarged to 5 cm at the same lesion and partially expanded into midbrain. The patient died on the 13th day of trauma. Based on retrospective interpretation, we conclude that clinical examinations, follow-up CT scans and blood examinations should be performed frequently as part of ICU management for all TBI patients in the early phase after trauma.

Outcome of Traumatic bilateral basal ganglia Hemorrhage: Rarest entity: Prospective study of five cases: Single institutional Experience

“…At discharge, 4 weeks after injury his GCS was E4VtrM2.outcome was poor. [23] Moriya T reported [24] a case of traumatic hematoma in the basal ganglia multiple gliding contusions in the left frontal and parietal lobe in 65 year old male that showed deterioration after arrival at the hospital The patient died on the 13th day of trauma .…”

Predictive models for occurrence of expansive intracranial hematomas and surgical evacuation outcomes in traumatic brain injury patients in Uganda: A prospective cohort study

“…This nding agrees with previous study which demonstrated that EIH are the most dangerous form of intracranial hematoma that occurs following traumatic brain injury (TBI) 38,50 . In addition, EIH appears to be associated with a high rate of neurological deterioration in patients with TBI 20,21 . What is not contested is that EIH patients face the risk of a large number of complications after the operation and that can further compromise their quality of life.…”

“…Currently, there is no effective treatment strategy to prevent EIH development in patients with TBI [15][16][17][18][19] . There is no clear effective therapy for EIH, thus also affecting the time of interventions making them experience varying prognoses, which at times can be poor 20,21 . Although there have been advances in quick and accurate diagnostic imaging procedures, the related morbidity and mortality following EIH are persistently high 13 .…”