Chapter 44 - Basal ganglionic hemorrhages

Summary

This chapter describes the classification of basal ganglionic hemorrhages (BGHs) and the clinical features and prognosis of each type. The BGH is classified into six regional types according to the arterial territories of the presumed primary bleeding focus of the hematomas: anterior type; middle type; posteromedial type; posterolateral type; lateral type; and massive type. The characterization of each individual type is discussed in the chapter. The prognosis of BGH depends on age, hematoma volume, initial neurological status, presence of intraventricular blood, presence of hematoma expansion, and quality of care in patients with spontaneous intracranial hemorrhage (ICH). General principles of medical care of patients with an ICH apply to all patients with BGHs. They include intracranial pressure (ICP) control with ICP monitoring, blood pressure (BP) management, and blood sugar level control. For most of the patients with the middle, posteromedial, or lateral type of BGH, medical management is enough.