Bilateral large traumatic basal ganglia haemorrhage in a conscious adult: A rare case report

Abstract

A case of a 38 year old fully conscious male, who presented with bilateral basal ganglia haematoma and extradural haematoma, is presented and the relevant literature is briefly reviewed.

Unstable Chest Surgical Management in Pregnancy: Case Report and Literature Review

“…This may be a medicolegal issue; as to whether the patient had a spontaneous basal ganglia bleed leading to the subsequent head injury or it was the head injury, which caused the basal ganglia hematoma. This rare entity has been previously reported in literature by Yanaka 10 have mentioned the only case of large bilateral TBGH with a fully conscious patient unlike the above-stated reports where the patients all had a poor GCS. The exact pathogenesis of basal ganglia hematoma is unclear; however, it is suggested that when a strong impact occurs over the vertex, forehead, or occipital region, the shearing force causes the brain to be displaced through the tentorial notch.…”

Traumatic brain injury presenting with bilateral basal ganglia hemorrhage

“…Fujioka et al proposed that a traumatic injury to middle cerebral artery could also be responsible for hemorrhages within the putamen [15]. Finally, Jain et al hypothesized that for their patient some degree of asymptomatic derangement of the microvasculature might have predisposed to the hematoma formation [11].…”

“…Adams et al considered 2 cm in the greatest diameter as the cutoff to define small or large lesions [2]. In addition small hemorrhagic lesions seem to be more associated to diffuse axonal injury (DAI) [11]. Actually the proposed pathophysiology mechanisms for TBGH have similarities to the mechanisms responsible for DAI.…”

“…ICP monitoring may be guaranteed like in other severe TBI lesions [12]. Patient with a TBGH which volume is higher than 25 ml, with enlarging volume on serial CT scans or patients with refractory raised intracranial pressure despite optimized clinical measures have worse outcomes [11]. This points to the need for a more aggressive management of these patientsthat is surgical hematoma drainage.…”

Delayed Massive Traumatic Hematoma in the Corpus Callosum: Two Case Reports with Literature Review

“…2) We hypothesize that the patient had some degree of asymptomatic derangement of the microvasculature of the CC, that made the microvasculature more vulnerable to stretching and/or shearing forces; this condition predisposed the patient to hematoma formation when subjected to trauma. 23) We assumed that the initial hemorrhage spot on the CC caused by the mild impact was minimal enough that it was either undetectable even with high-definition CT or that it had been already washed out when the first CT was performed; thus no obvious local neurological sign was apparent right after the injury, but it gave rise to symptoms several weeks later, presenting as a massive hematoma. 24,25) Additionally, post-traumatic headache may mask underlying chronic bleeding which also prolonged the course.…”