Rinsho Shinkeigaku (Clinical Neurology)

Case Report

Chronic intracerebral hemorrhage in the basal ganglia:
Report of two cases and prevalence

Ryuhei Kono, M.D.1), Norihiro Ishii, M.D., Ph.D.2), Kazuhiro Takamatsu, M.D.1), Yutaka Shimoe, M.D., Ph.D.1), Shinzo Ota, M.D.2) and Masaru Kuriyama, M.D., Ph.D.1)

1)Department of Neurology, Brain Attack Center Ota Memorial Hospital
2)Department of Neurosurgery, Brain Attack Center Ota Memorial Hospital

Two patients presented with chronic intracerebral hemorrhage (CIH) in the basal ganglia. A 48-year-old man (Case 1) was admitted to our hospital because of hypertensive right putaminal hemorrhage. On day 14, his hematoma surrounding the edema had grown without re-bleeding as seen on head CT, which was then removed endoscopically on day 28. Biopsied specimen of the hematoma capsule showed granulomatous tissue with vascularity. A 54-year-old man (Case 2) was admitted to our hospital because of bilateral intracerebral hemorrhage in the basal ganglia of the right putamen and left thalamus. On head CT, both hematomas were found to be enlarged without change in his symptoms on the 11th day after onset. His symptoms and signs subsided with medical treatment for 4 weeks. Cerebral angiography showed no abnormality of cerebral vessels. The patient had intracerebral hemorrhage in the basal ganglia or cerebral lobes 5 times in the past 10 years. Although no arterial or venous abnormality was detected by cerebral angiography and MRI/MRA, the abnormality of vessels including capillaries was strongly suggested. CIH should be considered a possibility when the symptom or hematoma does not improve even 2 weeks after the onset. The prevalence of CIH in our hospital was 0.08% of total intracerebral hemorrhages and 0.15% of hemorrhages in the basal ganglia.
Full Text of this Article in Japanese PDF (797K)

(CLINICA NEUROL, 55: 490|496, 2015)
key words: chronic intracerebral hemorrhage, basal ganglia, capsule, treatment, prevalence

(Received: 19-Jan-15)