Basal ganglia hemorrhage

Synonyms
Basalganglienblutung
ICD-10
I61.0
ICD-11
NA07.81, 8B00.0

A basal ganglia hemorrhage is an intracerebral hemorrhage in the region of the basal ganglia. This is a typical site for spontaneous intracerebral hemorrhages, particularly those caused by hypertension.

Etiology

Basal ganglia hemorrhages usually occur as spontaneous intracerebral hemorrhages, but in rare cases (~3 %) they may also be traumatic in origin[^2].

Treatment

In most cases, these types of hemorrhages can be treated conservatively without neurosurgical intervention. In some cases, an external ventricular drainage (EVD) and\/or intracranial pressure monitoring may be indicated.

Classification

In principle, basal ganglia hemorrhages are distinguished according to whether or not the bleeding extends into the Ventricular system.

Basal ganglia hemorrhage without intraventricular extension

Basal ganglia hemorrhages without intraventricular extension are defined as hemorrhages in which the bleeding is confined to the brain parenchyma in the region of the basal ganglia, without extension into the Ventricular system.

Basal ganglia hemorrhage on CT
CT imaging of a hypertensive basal ganglia hemorrhage without intraventricular extension.

Basal ganglia hemorrhage with intraventricular extension

If bleeding into the basal ganglia ruptures into the Ventricular system, the hemorrhage is referred to as a basal ganglia hemorrhage with intraventricular extension. The presence of blood in the ventricular system increases the risk of Obstructive hydrocephalus as well as Malresorptive hydrocephalus, necessitating an External ventricular drainage.

Basal ganglia hemorrhage with intraventricular extension
CT image of a patient with a left-sided basal ganglia hemorrhage with extension into the ventricular system.

Prognosis

A 2006 study of 116 patients demonstrated that the presence of intraventricular extension in basal ganglia hemorrhage had no effect on long-term outcome[^1].

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