Basal ganglia hematomas in severely head injured patients: clinicoradiological analysis of 37 cases

Boto, G.R.; Lobato, R.D.; Rivas, Juán J.; Gomez, Pedro A.; Lama, A. de la; Lagares, Alfonso

doi:10.3171/jns.2001.94.2.0224

Cited by 45 publications

(97 citation statements)

References 31 publications

(36 reference statements)

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“…[2][3][4][5][6][7][8]13,16,[19][20][21] As we observed in the present case, many studies have shown a favorable outcome for patients with TBGH. …”

Section: Resultssupporting

confidence: 71%

“…18 The management of the TBGH depends on the neurological status, size of the hematoma, presence of mass effect, and the options include conservative management, open surgery, CT-guided stereotactic, or ultrasound-guided aspiration. [2][3][4]10 In present case, in view of the smaller size of the lesion, we managed the patient conservatively. Traumatic basal ganglia hemorrhage needs to be differentiated from jpmer spontaneous basal ganglionic hematomas.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Traumatic Basal Ganglia Hematoma

2014

Journal of Postgraduate Medicine, Education and Research

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Traumatic basal ganglia hemorrhage (TBGH) is characterized as a hemorrhagic lesion located in the basal ganglia or in internal capsule or thalamus. Outcome of TBGH is mainly determined by the extent of associated brain injuries particularly the larger the size, presence of coagulation disorders, diffuse, presence of intraventricular or brain stem hemorrhage, age >60, pupillary asymmetry, abnormal motor response, and severe head injury all are associated with poorer outcome. In present case, we discuss a case of adult male traumatic basal ganglia hemorrhage with good outcome.

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“…[2][3][4][5][6][7][8]13,16,[19][20][21] As we observed in the present case, many studies have shown a favorable outcome for patients with TBGH. …”

Section: Resultssupporting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Traumatic Basal Ganglia Hematoma

2014

Journal of Postgraduate Medicine, Education and Research

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“…The pioneering work of Adams et al [2] in 1986 identified TBGH as a distinct diagnosis rather than a spectrum of severe head injuries or diffuse axonal injuries, which was subsequently confirmed by many [1,5,6,7]. Its is mostly encountered in high-velocity trauma; however, falls from height are a frequent cause as well in children as recorded in 38% of our patients, which is similar to other studies [1,5,6,7,8,9]. …”

Section: Discussionmentioning

confidence: 97%

“…In 1980 Maki et al [3], in their study on 7 children, reported the role of anterior stretch on the lateral branches of the perforators of the middle cerebral artery in traumatic TBGH. Boto et al [5], in 2001, reported the role of acceleration and deceleration during trauma as a cause of stretching and tearing of pallidal branches of the anterior choroidal artery, which produces small multiple hematomas and contusions in the region of the basal ganglia.…”

Section: Discussionmentioning

confidence: 99%

Outcome of Pediatric Patients with Traumatic Basal Ganglia Hematoma: Analysis of 21 Cases

Kurwale

Gupta

Mahapatra³

2010

Pediatr Neurosurg

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Objectives: To analyze the outcome of a pediatric population with traumatic basal ganglia hematoma (TBGH). Methodology: Patients <15 years of age with TBGH were studied for mode of injury, severity of injury on admission, Glasgow coma scale (GCS) score on admission, radiology, intervention and overall outcome. Observations: Twenty-one patients (male:female = 4:1) with a mean age of 7.2 ± 3.7 years (range 0.33–15 years) were studied. High-velocity trauma (52%) followed by fall from height (38%) were the leading causes. Seventy-six percent of the patients had severe head injury. The mean GCS score on admission was 6.0 ± 2.5 (range 3–12), while the mean GCS score of the group with severe head injury was 4.81 ± 1.7 (range 3–7). Eleven (52.4%) patients had isolated basal ganglia hematoma while 10 (47.6%) had other associated intracranial injuries. Only 3 patients required surgical interventions. Eleven patients (52.4%) expired during their hospital stay. At discharge, 9 (42.9%) had a poor, nonfunctional outcome (Glasgow outcome scale, GOS 2, 3). Conclusion: The severity of head injuries and GCS score on admission mainly determined the ultimate outcome in pediatric TBGH. The mode of injury or associated intracranial injuries did not change the outcome. The presence of TBGH in severely head-injured patients worsens the prognosis and outcome.

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“…After complete clinical and neurological evaluations were peformed, computed tomography (CT) scans were regularly obtained and the volume of the hematomas, as well as presence or absence of hydrocephalus were considered. The volume of the hematomas was measured according to the formula: length x width x height x 0.5 [10][11][12] . Both, length and width, were obtained from the CT slices demonstrating the largest hyperdense area of the hematomas.…”

Section: Methodsmentioning

confidence: 99%

Intraventricular pressure monitoring in patients with thalamic and ganglionic hemorrhages

Hamani

Zanetti

Pinto

et al. 2003

Arq. Neuro-Psiquiatr.

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In the present study, we have evaluated the use of intraventricular pressure catheters in thalamic and ganglionic hemorrhages. Ten patients admitted in our Emergency Department in Glasgow Coma Scale (GCS) equal or below 13 enrolled the study (at least one point should have been lost in the eye opening score to exclude purely aphasic patients that were fully alert). After a complete clinical and neurological evaluation, computed tomography scans were obtained and the volume of the hematomas, as well as presence or absence of hydrocephalus, were considered. Intraventricular pressure catheters connected in parallel to external derivation systems were implanted and patients were thereafter sent to the ICU. Patients that presented mass effect lesions with sustained increased ICP levels or clinical and neurological deterioration were submitted in addition, to the surgical evacuation of the hematomas. Clinical evolution, complications and the rehabilitation of the patients were recorded. Clinical outcome was assessed with the Glasgow Outcome Score. In all but three patients the initial intracranial pressure levels were bellow 20 mmHg (mean for all patients was 14.1 +/- 6.5 mmHg). Notwithstanding, these three patients were extremely difficult to treat. For this group of patients mortality was 100%. Among the patients that presented ICP levels bellow 20 mmHg, 04 developed hydrocephalus and 03 did not display ventricular dilation. As expected, the major benefits concerning the intraventricular pressure catheters connected in parallel with external derivation systems were observed in the group of patients that presented ICP levels bellow 20 mmHg and had hydrocephalus. Mild non-statistically significant correlations for all the three groups were achieved either when the initial GCS and ICP levels (r=-0.28, p=0.43) or when ICP levels and the volumes of the hematomas were compared (r=0.38, p=0.28). In addition, no significant correlations were observed concerning the final outcome of the patients and the variables previously evaluated.

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Basal ganglia hematomas in severely head injured patients: clinicoradiological analysis of 37 cases

Cited by 45 publications

References 31 publications

Traumatic Basal Ganglia Hematoma

Traumatic Basal Ganglia Hematoma

Outcome of Pediatric Patients with Traumatic Basal Ganglia Hematoma: Analysis of 21 Cases

Intraventricular pressure monitoring in patients with thalamic and ganglionic hemorrhages

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