Analysis of the Predictors and Outcomes in Patients of Traumatic Basal Ganglia Bleed with Review of Literature

Background: Traumatic basal ganglia hematoma is a rare condition defined as presence of hemorrhagic lesion located in the basal ganglion (caudate nucleus, putamen and globus pallidus) and its neighbouring structures like thalamus and internal capsule2. Objective: The purpose of this study is to assess the outcome and predictors in patients with traumatic basal ganglia bleed. Material& methods: The clinical course of 31 head injury patients in whom CT had shown basal ganglia bleed admitted between august 2017 to april 2019 to our hospital, were prospectively analyzed. Results: The patient in this study ranged from 6 years to 80 years in age. Most of the cases (77.42 %) were of road traffic accident. Mean GCS at the arrival at the hospital was 8.87. Volume of hematoma ranged from 1cc to 60cc.80.65 % of patients in this study had associated head injury.70.94 % of the patients had hemiparesis.6 patients had pupil asymmetry at the time of admission.21 cases (67.74 %) had good prognosis (GCOS score of 4 or 5) while 10 patients had bad prognosis (GCOS score of less than or equal to 3). Nine patients expired. In two cases surgical evacuation of hematoma was done. Rest were managed conservatively There were five cases of bilateral TBGH and all cases had associated brain injuries. Three patients out of these five expired. Conclusion: TBGH mainly occurs in young adult males with history of road traffic accident. Most of these cases have associated brain injuries. Prognosis of TBGH correlates with GCS at presentation and pupil asymmetry. Also we observed that presence of associated head injuries and larger volume of hematomas have poorer outcome. Outcome of isolated TBGH is excellent.