Basal ganglia hemorrhage with intraventricular extension

Case contributed by Dr Derek Smith

Presentation

Unconscious; GCS 9 (E4 V1 M4 right best side). Last seen well 6 hours previously. Previous lacunar infarcts, seizures and history of alcohol/narcotic abuse.

Patient Data

Age: 60 years
Gender: Male

Large right basal ganglia parenchymal hemorrhage with extensive intraventricular extension; blood expands the third, fourth and right lateral ventricles with blood products layering in the occipital horns and foramen magnum. This results in hydrocephalus with marked distension of the temporal horns.

No aneurysm or other vascular abnormality on angiogram. No features of underlying mass.

Old bilateral basal ganglia lacunes.

Case Discussion

Large intraventricular hemorrhage extending from a right basal ganglia parenchymal bleed. This site of hemorrhage is typically associated with long-standing hypertension.

Given the extent of blood, hydrocephalus and neurological deficit no active management was performed and best supportive care delivered in this case.

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Case information

rID: 74569
Published: 27th Feb 2020
Last edited: 28th Feb 2020
Inclusion in quiz mode: Included

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