神経外傷
Online ISSN : 2434-3900
症例報告
外傷性基底核出血:自験6例の検討
榊原 陽太郎田口 芳雄中村 歩希小野寺 英孝和久井 大輔川口 公悠樹
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2020 年 43 巻 1 号 p. 23-27

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Objectives: As traumatic basal ganglia hemorrhage (TBGH) is uncom­mon, we retrospectively analyzed our own previous TBGH cases in order to investigate the clinical characteristics of this rare hemorrhagic lesion.

Materials and methods: From January 2012 to June 2018, we treated 6 TBGH cases at our institution. We reviewed the frequency of TBGH cases in acute head trauma, patient’s age, sex, cause of injury, Glasgow coma scale at the time of admission, TBGH site, associated intracranial lesions, treatment method and outcomes in each patient.

Results: During the same period, we treated 214 patients with acute head trauma, and determined the TBGH frequency to be 2.8%. Patients evaluated in the current analysis included 5 males and 1 female, with ages ranging from 17 to 86 years, (mean age of 43.8 years). Cause of injury included traffic accidents in 3, falls in 2, and falling downstairs in 1 patient. Glasgow coma scale at the time of admission was 15 in 1, and less than 8 in the other 5 patients. TBGH sites included the putamen in 3 and the globus pallidus in 3 patients. Computed tomography detected associated intracranial lesions in all cases, with acute subdural hematoma (aSDH) found in 3, traumatic subarachnoid hemorrhage in 2, skull fracture in 2, and corpus callosum injury in 1 patient. With the exception of 1 case, surgical procedures were performed in all patients. Evacuation of TBGH via craniotomy was carried out in 1 patient, and evacuation of aSDH in 3 patients, and placement of external ventricular drainage and intracranial pressure monitoring in 1 patient. At the time of discharge, outcomes based on the Glasgow outcome scale were moderately disabled in 1, and severely disabled in 3, with death occurring in 2 patients.

Conclusions: Clinical characteristics of TBGH were evaluated based on our previous cases. Although TBGH is uncommon, medical staff need to have a basic knowledge of this traumatic injury.

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© 2020 日本脳神経外傷学会
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