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Simultaneous bilateral hypertensive basal ganglia hemorrhage
Affiliations- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
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Abstract
Hypertension is the single most important risk factor for intracerebral hemorrhage (ICH) and often leads to solitary hematoma. Multiple spontaneous simultaneous ICH is not common, and bilateral hemorrhages occurred in symmetrical basal ganglia is extremely rare. Most reported cases accepted conservative treatment and suffered extremely poor outcome.
Case reportA 57-year-old male became unconscious when having supper and was transported to our emergency room immediately. Non-contract CT brain scanning showed simultaneous bilateral hypertensive basal ganglia hemorrhage; he was treated by stereotactic aspiration and thrombolysis for both sides, with subsequent thrombolysis and clot aspiration through hematoma-indwelling catheter. The hematomas were almost totally cleared within a week. His condition improved gradually. Nearly 10 months after onset, he could chow and swallow food, controlling bowels and bladder all by himself, but need some help when feeding and using toilet.
ConclusionSimultaneous bilateral hypertensive basal ganglia hemorrhage is a devastating cerebrovascular disease with significant high morbidity and mortality. Stereotactic aspiration and thrombolysis is a safe and effective way to clear hematomas within short time, thus reducing the neurological impairment from hematoma mass effect and secondary brain injury, improving prognosis.
Abstract
Hypertension is the single most important risk factor for intracerebral hemorrhage (ICH) and often leads to solitary hematoma. Multiple spontaneous simultaneous ICH is not common, and bilateral hemorrhages occurred in symmetrical basal ganglia is extremely rare. Most reported cases accepted conservative treatment and suffered extremely poor outcome.
Case reportA 57-year-old male became unconscious when having supper and was transported to our emergency room immediately. Non-contract CT brain scanning showed simultaneous bilateral hypertensive basal ganglia hemorrhage; he was treated by stereotactic aspiration and thrombolysis for both sides, with subsequent thrombolysis and clot aspiration through hematoma-indwelling catheter. The hematomas were almost totally cleared within a week. His condition improved gradually. Nearly 10 months after onset, he could chow and swallow food, controlling bowels and bladder all by himself, but need some help when feeding and using toilet.
ConclusionSimultaneous bilateral hypertensive basal ganglia hemorrhage is a devastating cerebrovascular disease with significant high morbidity and mortality. Stereotactic aspiration and thrombolysis is a safe and effective way to clear hematomas within short time, thus reducing the neurological impairment from hematoma mass effect and secondary brain injury, improving prognosis.
Keywords
Basal ganglia hemorrhage, Hypertension, Stereotaxic techniques, Bilateral
About this articleTitle
Simultaneous bilateral hypertensive basal ganglia hemorrhage
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
275-279
Page views
328
Article views/downloads
664
DOI
10.1016/j.pjnns.2016.03.003
Bibliographic record
Neurol Neurochir Pol 2016;50(4):275-279.
Keywords
Basal ganglia hemorrhage
Hypertension
Stereotaxic techniques
Bilateral
Authors
Jingwang Zhao
Zhijuan Chen
Zengguang Wang
Qing Yu
Weidong Yang
