The Clinical analysis of 130 spontaneous intracebral & cerebellar hematoma confirmed by brain CT & admitted to this neurosurgical clinic past years & 5 months were made with literature review. 1) The age incidence showed increase over fourth decade and male to female ratio was 56.1:43.9. 2) 50.4% of total patients showed hypertension but 40.3% did not checked their B.P. & 9.3% had normal B.P. before cerebral hemorrhage. Among 50.4% of hypertension cases, 72% received antihypertensive treatment intermittently, 2.9% regularly and the rest 24.3% did not. 3) 69.7% of hematoma located in basal ganglia & thalamus. In nonoperated patients, the morbidity & mortality showed no marked difference in their location except pontine & cerebellar hematomas. In operated patients the morbidity & mortality was prominent in putaminal hemorrhage than in thalamus and cerebellum. Most of putaminal hematoma had semicomatose or comatose mental state and ventricular hemorrhage in 87.5%. 4) The morbidity & mortality increased in proportion to size of hematomas, grade of unconsciousness in admisson and state of intraventricular hemorrhage. 5) About time interval from ictus to operation, the patients within first 24 hours are 29 cases(51.1%) and the next 24 hours are 13 cases(26.5%). The mortality rate of two groups were 55.1% & 53.8% respectively but no death in the patients with operation performed after 48 hours. 6) The morbidity & mortality rate were as follows. In the non operated patients (90 patients), no or mild neurological deficits:22.2% moderate:21.1% severe:20% and moribund or death:36.6%. In the operated patients no or mild neurological deficits:16.3% moderate:18.4% severe:18.4% and moribund or death:46.9%. The results of total patients showed no or mild neurological deficits:20.1%, moderate:20.1%, severe:19.4% and moribund or death:40.2%.
Basal Ganglia ; Brain ; Cerebellum ; Cerebral Hemorrhage ; Coma ; Female ; Hematoma* ; Hemorrhage ; Humans ; Hypertension ; Incidence ; Male ; Mortality ; Putaminal Hemorrhage ; Thalamus ; Unconsciousness

The author analyzed 169 cases of spontaneous intracerebral hemorrhages at the basal ganglia and thalamus, who had been admitted to Jeonju Presbyterian Medical Center from 1975 to 1979. Intracerebral hematoma was confirmed by angiography and the amount of hematoma was divided as small, medium or large according to the angiographic evidence. Among the 169 cases, 145 cases underwent appropriate medical or surgical treatment. 63 cases were treated conservatively and 82 cases were operated ; 22 cases of frontal approach, 51 cases of temporal approach, and 9 cases of extraventricula diainage of clot. Results obtained are as follows : 1. The common pridiection age group was from the fifth to the seventh decades, which was 90.5% of all cases. The ratio of male to female was about 2 to 1. 2. putaminal hemorrhage was 65.1%, and thalamic hemorrhage was 16.6%. 3. Angiographic evidence of arteriosclerosis was seen in 86.4%. 4. The worse prognostic factors were related to age(over 65), site and size of hematoma, and mental state on admission. 5. With conservative management 49.2% were improved, 6.3% not improved, 44.4% moribund or dead. 6. With surgical treatment 58.5% were improved, 3.7% not improved, 37.8% moribund or dead. 7. Microsurgical temporal approach proved to have the following advantages over frontal approach. (1) Better outcome was found in this approach(64.7% vs 54.4%). (2) The distance to the hematoma was closer in temporal approach, and so total removal of hematoma and complete control of bleeding sources with less surrounding structural damages were possible. 8. Early operation seems to be more effective than delayed operation in the cases of large hematoma with deteriorating neurological signs.
Angiography ; Arteriosclerosis ; Basal Ganglia* ; Cerebral Hemorrhage* ; Female ; Hematoma ; Hemorrhage ; Humans ; Jeollabuk-do ; Male ; Protestantism ; Putamen ; Putaminal Hemorrhage ; Thalamus*

The most common etiology of spontaneous, non-traumatic intracerebral hemorrhage is hypertension. One of the most decisive factors for the determination of etiology is location of the hemorrhage. Here, we report on a 53-year-old female patient who was admitted with left putaminal hemorrhage. She did not have prominent vascular risk factors other than fundoscopic signs of hypertensive retinopathy. Magnetic resonance imaging and angiography revealed arteriovenous malformation (AVM) in the basal ganglia, which was fed by the lateral lenticulostriate artery. This case suggests that we should consider an AVM-related hemorrhage in relatively young stroke patients, regardless of hematoma location or presence of accompanying hypertension.
Angiography ; Arteries ; Arteriovenous Malformations ; Basal Ganglia ; Cerebral Hemorrhage ; Female ; Hematoma ; Hemorrhage ; Humans ; Hypertension ; Hypertensive Retinopathy ; Magnetic Resonance Imaging ; Middle Aged ; Putaminal Hemorrhage ; Risk Factors ; Stroke

No abstract available.
Basal Ganglia Hemorrhage ; Basal Ganglia ; Catheters ; Drainage ; Status Epilepticus

"Mirror-writing" is stript that runs in the direction opposite to normal with the individual letters also reversal. Several theories, including motor, visual dominance, spatial disorientation and supplementary motor hypotheses, have been proposed to explain "mirror-writng". With reviewing some of literatures, we present two cases of "mirror-writing" in association with bilateral basal ganglia hemorrhage and right frontal hematoma, respectively.
Basal Ganglia Hemorrhage ; Cerebral Hemorrhage* ; Hematoma ; Humans

The preferred site of spontaneous intracerebral hemorrhage(SICH) is the supratentorial area, especially the basal ganglia. Large hematomas frequently spread into the ventricle, and in the case of intraventricular hematomas, varying degrees of fresh blood are found within the subarachnoid space. Cases in which SICH of the basal ganglia ruptures the insular cortex and causes thick subarachnoid hemorrhage(SAH) in the basal cisterns, are, however, rare. The authors report a rare case of putaminal SICH with intraventricular hemorrhage(IVH) and SAH in the basal cisterns. This 58-year-old female was stuporous on admission. Neurological examination revealed Glasgow coma scale score 7, left hemiparesis, positive Babinski's sign and neck stiffness. Brain CT showed a large intracerebral hematoma in the right basal ganglion and associated intraventricular hematoma and SAH in the basal cistern. Cerebral angiography demonstrated a small saccular aneurysm at the right M1. Right pterional and trans-sylvian approach revealed thick SAH in the sylvian fissure and a small unruptured aneurysm at the early bifurcation of the middle cerebral artery. The putaminal hematoma had ruptured into the sylvian fissure through a natural opening at the insular cortex between M2 branches. This case illustrates that hypertensive SICH should be included in the differential diagnosis of basal cistern SAH associated with SICH.
Aneurysm ; Basal Ganglia ; Brain ; Cerebral Angiography ; Diagnosis, Differential ; Female ; Ganglion Cysts ; Glasgow Coma Scale ; Hematoma ; Humans ; Middle Aged ; Middle Cerebral Artery ; Neck ; Neurologic Examination ; Paresis ; Putaminal Hemorrhage* ; Reflex, Babinski ; Rupture ; Stupor ; Subarachnoid Hemorrhage* ; Subarachnoid Space

Using diffusion tensor tractography (DTT), we demonstrated injury of the arcuate fasciculus (AF) in the nondominant hemisphere in two patients who showed subfalcine herniation after intracerebral hemorrhage (ICH) in the dominant hemisphere. Two patients (patient 1 and patient 2) with ICH and six age-matched control patients who have ICH on the left corona radiata and basal ganglia without subfalcine herniation were recruited for this study. DTT was performed at one month after onset in patient 1 and patient 2. AFs of both hemispheres in both patients were disrupted between Wernicke's and Broca's areas. The fractional anisotropy value and tract numbers of the right AFs in both patients were found to be more than two standard deviations lower than those of control patients. In contrast, the apparent diffusion coefficient value was more than two standard deviations higher than those of control patients. Using the configuration and parameters of DTT, we confirmed injury of the AF in the nondominant hemisphere in two patients with subfalcine herniation following ICH in the dominant hemisphere. Therefore, DTT would be a useful tool for detection of underlying injury of the AF in the nondominant hemisphere in patients with subfalcine herniation.
Anisotropy ; Basal Ganglia ; Cerebral Hemorrhage* ; Diffusion ; Humans

To evaluate the current status of cerebrovascular disease in Korea, we performed a retrospective study on 1260 cases of stroke who had been admitted to or had visited Seoul National University Hospital, Choongnam National University Hospital, Hanyang University Hosipital, and Chung Ang University Hospital in the period from Jul 1, 1986 to Jun 30, 1987. The incidence was highest in sixth and seventh decades. Ischemic stroke (51.1%) was more common thar, hemorrhagic stroke (47.6%), and thrombotic infarction was the leading type (37.7%) of all kinds of strokes. Middle cerebral arterial territory was the most commonly involved site in thrombotic and embolic stroke. Among intracerebral hemorrhage, basal ganglia hemorrhage was found in 47.7%, and was followed by thalamic(23.8%), lobar (15.3%) and pontine hemorrhage (9.4%). Primary intraventricular hemorrhage (IVH) was relatively rare (8 cases, 7.5% of all IVH), and hemorrhages in basal ganglia or thalamus frequently induced secondary IVH. 16 cases (10.7%) of subarachnoid hamorrhage were accompanied by secondary IVH. This study suggests changing trends of stroke in Korea, and multicenter prospective study using stroke registry is requird for confirmation.
Basal Ganglia ; Basal Ganglia Hemorrhage ; Cerebral Hemorrhage ; Hemorrhage ; Incidence ; Infarction ; Korea* ; Retrospective Studies ; Seoul ; Stroke ; Thalamus

OBJECTIVE: The clinico-radiologic features of the spontaneous basal ganglia hemorrhage (BGH) may often differ one from another, according to its regional location. Therefore, we attempted to classify the BGH into regional subgroups, and to extrapolate the distinct characteristics of each group of BGH. MATERIALS AND METHODS: A total of 103 BGHs were analyzed by retrospective review of medical records. BGH was classified according to four subgroups; anterior BGH; posterior BGH; lateral BGH; massive BGH. RESULTS: The most common BGH was the posterior BGH (56, 54.4%), followed by the lateral BGH (26, 25.2%), the massive BGH (12, 11.7%), and the anterior BGH (9, 8.7%). The shape of hemorrhage tended to be round in anterior, irregular in posterior, and ovoid in lateral BGH. A layered density of hematoma on initial computed tomography showed correlation with hematoma expansion (p = 0.016), which was observed more often in the postero-lateral group of BGH than in the anterior BGH group. Relatively better recovery from the initial insult was observed in the lateral BGH group than in the other regional BGH groups. The proportion of poor outcome (modified Rankin scale 4, 5, 6) was 100% in the massive, 41.1% in the posterior, 34.6% in the lateral, and 0% in the anterior BGH group. CONCLUSION: We observed that BGH can be grouped according to its regional location and each group may have distinct characteristics. Thus, a more sophisticated clinical strategy tailored to each group of BGHs can be implemented.
Basal Ganglia ; Basal Ganglia Hemorrhage* ; Classification* ; Hematoma ; Hemorrhage ; Medical Records ; Retrospective Studies

Bilateral traumatic hemorrhage of the basal ganglia is an extremely rare neuropathologic entity. This report describes a 50-year-old man with bilateral basal ganglia hemorrhage with occipital fracture of the skull after head trauma. The mechanism of development of traumatic hemorrhage of the basal ganglia has been not clear. But, it is presumed to be secondary to rupture of the lenticulostriate or anterior choroidal artery by shearing as a result of acceleration/deceleration forces. We briefly summarize our uncommon case and discuss its possible mechanisms.
Arteries ; Basal Ganglia Hemorrhage ; Basal Ganglia* ; Choroid ; Contusions ; Craniocerebral Trauma ; Hemorrhage* ; Humans ; Middle Aged ; Rupture ; Skull