Massive putaminal-thalamic nontraumatic hemorrhage

• Published in: Computerized medical imaging and graphics Vol. 16; no. 5; pp. 353 - 357
• Main Authors: Weisberg, Leon A., Elliott, Debra, Shamsnia, Morteza
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Ltd 01.09.1992; Elsevier Science
• Subjects: Adult; Biological and medical sciences; Cerebral Hemorrhage - diagnostic imaging; Cerebral Hemorrhage - etiology; Humans; Hypertension; Hypertension - complications; Intracerebral hemorrhage; Investigative techniques, diagnostic techniques (general aspects); Male; Massive hemorrhage; Medical sciences; Middle Aged; Nervous system; Putamen; Putamen - diagnostic imaging; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Retrospective Studies; Sensitivity and Specificity; Thalamus; Thalamus - diagnostic imaging; Tomography, X-Ray Computed; Hypertension; Thalamus; Massive hemorrhage; Putamen; Intracerebral hemorrhage; Human; Radiodiagnosis; Computerized axial tomography; Hemorrhage; Cerebral disorder
• ISSN: 0895-6111; 1879-0771
• DOI: 10.1016/0895-6111(92)90149-4

Fourteen patients developed massive putaminal-thalamic hemorrhage. All patients were young black men. They were hypertensive but without chronic hypertensive vascular changes. They had been treated with antihypertensive medication for less than 3 yr. All patients presented with a prodromal headache beginning 18–30 h before the brain hemorrhage. Initial clinical signs were heralded by a change in the headache pattern and vomiting. All patients became comatose and hemiplegic within 4–12 h. CT showed a hyperdense putaminal-thalamic hemorrhage which was 60 to 86 mm in maximal diameter. There was marked mass effect with secondary intraventricular extension. All patients died within 72 h, despite rapid and adequate blood pressure control and maximal medical treatment of cerebral edema and increased intracranial pressure.