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Bilateral Traumatic Hemorrhage in the Basal Ganglia:Report of two cases Kiyoyuki YANAKA 1 , Taihei EGASHIRA 1 , Yutaka MAKI 1 , Shingo TAKANO 1 , Masao OKAZAKI 1 , Yuji MATSUMARU 1 , Takao KAMEZAKI 2 , Yukio ONO 2 , Tadao NOSE 3 1Department of Neurosurgery, Kitaibaraki-City General Hospital 2Department of Neurosurgery, Kensei General Hospital 3Department of Neurosurgery, Institute of Clinical Medicine, University of Tsukuba Keyword: Basal ganglia , Diffuse axonal injury , Head injury , Intracerebral hematoma , Shearing injury pp.369-373
Published Date 1991/4/10
DOI https://doi.org/10.11477/mf.1436900247
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Abstract

Hematomas of the basal ganglia in head injury have long been recognized by pathologists with an interst in head injury but their mechanism has not been revealed clearly. We report two cases of bilateral traumatic he-morrhage in the basal ganglia.

Case ♯ 1, a 17-year-old male was admitted to our hospital immediately after a traffic accident. Neurologi-cal examination revealed that the patient was comatose and had right hemiparesis. CT scan showed bilateral hemorrhage of the basal ganglia and subarachnoid he-morrhage in the perimesencephalic cistern. MRI showed high signal intensity areas in the bilateral basal ganglia, perimesencephalic cistern, cerebral white mat-ter and corpus callosum. The patient was diagnosed as having diffuse axonal injury coinciding with bilateral hemorrhage of the basal ganglia. Stereotactic aspiration for the hematoma of the left basal ganglia was carried out.

Case ♯ 2, a 75-year-old male was admitted immedi-ately after falling from the roof of his house. Neurolo-gical examination revealed no neurological deficit ex-cept for headache and nausea. CT scan on the day of injury revealed no abnormality. But CT scan 12 hours following the injury showed bilateral hemorrhage of the basal ganglia. Blood pressure of the patient was within, normal range and he was diagnosed as having traumatic bilateral intracerebral hematoma. Conserva-tive treatment was carried out and the patient was dis-charged 7 days after injury with no neurological deficit. The mechanism of traumatic hemorrhage of the basal ganglia has not been clear. In case # 1, diffuse axonal injury (DAI) may have played an important role in the bilateral hemorrhage. But in case # 2, non-DAI factor such as vasoparalysis syndrome may have existed. The mechanism of bilateral traumatic hemorrhage of the basal ganglia is complicated. Therefore these caess must be classified as either DAI or non-DAI.


Copyright © 1991, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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