Abstract
A case of traumatic hematoma in the basal ganglia that showed deterioration after arrival at the hospital was reported. A 65-year-old man crashed into the wall while riding a motorcycle. His Glasgow coma scale was E3V4M6 and showed retrograde amnesia and slight right motor weakness. Because head CT in the secondary trauma survey showed subarachnoid hemorrhage in the right Sylvian fissure and multiple gliding contusions in the left frontal and parietal lobe, he was entered into the intensive care unit for diagnosis of diffuse brain injury. He showed complete muscle weakness of left upper and lower limbs 5 h after the accident. Head CT newly showed hematoma, 2 cm in diameter, in the right basal ganglia. The patient vomited following the CT scan, and so his consciousness suddenly deteriorated into a stupor. We performed head CT again. The hematoma had enlarged to 5 cm at the same lesion and partially expanded into midbrain. The patient died on the 13th day of trauma. Based on retrospective interpretation, we conclude that clinical examinations, follow-up CT scans and blood examinations should be performed frequently as part of ICU management for all TBI patients in the early phase after trauma.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Andrews BT (1988) Management of delayed posttraumatic intracerebral hemorrhage. Contemp Neurosurg 10:1–6
Inoue A, Kohno K, Takeda T, Takechi A, Kohno K, Ishii D, Sasaki U (2005) Eight head trauma patients who talk and die. J Jpn Assoc Acute Med 16:593–599
Kawamata T, Katayama Y (2002) Head injured patients who talk and deteriorate: analysis of 86 cases registered on The Japan Neurotrauma Data Bank. Neurotraumatology 25:205–209
Marshall LF, Toole BM, Bowers SA (1983) The National Traumatic Coma Data Bank. Part 2: patients who talk and deteriorate: implications for treatment. J Neurosurg 75:285–288
Pondaag W (1978) Disseminated intravascular coagulation in head-injured patients. Adv Neurosurg 6:159–163
Robato RD, Rivas JJ, Gomez PA, Castafida M, Cafizal JM, Sarabia R, Cabrera A, Murioz MJ (1991) Head-injured patients who talk and deteriorate into coma. Analysis of 211 cases studied with computerized tomography. J Neurosurg 75:256–261
Rockswold GL, Pheley PJ (1993) Patients who talk and deteriorate. Ann Emerg Med 22:1004–1007
Takahashi H, Urano T, Takeda Y, Nagai N, Takeda A (1997) A fibrinolytic parameters as an admission prognostic marker of head injury in patients who talk and deteriorate. J Neurosurg 86:367–388
Tan JE, Ng I, Lim J, Wong HB, Yeo TT (2004) Patients who talk and deteriorate: a new look at an old problem. Ann Acad Med 33:489–493
Yamagami I, Yamaura A, Isobe K (1993) Pathogenesis and management of secondary neural damage in head trauma patients: Analysis of patients who talk and deteriorate “fulminantly”. No Shinkeigeka 21:129–133
Conflict of Interest
We declare that we have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer-Verlag Wien
About this paper
Cite this paper
Moriya, T., Tagami, R., Furukawa, M., Sakurai, A., Kinoshita, K., Tanjoh, K. (2013). A Case of Traumatic Hematoma in the Basal Ganglia That Showed Deterioration After Arrival at the Hospital. In: Katayama, Y., Maeda, T., Kuroiwa, T. (eds) Brain Edema XV. Acta Neurochirurgica Supplement, vol 118. Springer, Vienna. https://doi.org/10.1007/978-3-7091-1434-6_27
Download citation
DOI: https://doi.org/10.1007/978-3-7091-1434-6_27
Published:
Publisher Name: Springer, Vienna
Print ISBN: 978-3-7091-1433-9
Online ISBN: 978-3-7091-1434-6
eBook Packages: MedicineMedicine (R0)