Clinical Analysis of Traumatic Hemorrhage in Child's Basal Ganglia: Eight Cases

ABSTRACT

Recently, the detection of traumatic intracerebral hematoma has been greatly expedited by the advent of computed tomography. However, traumatic basal ganglia hemorrhage(TBGH) in child have remained rare. The authors obtained following results with analysis of clinical features and outcome in 8 cases of child's TBGH who had been treated at the department of neurosurgery, chonnam university hospital from January 1984 to December 1986. 1) Age distribution was ranged from 3 to 9 years with an average age 5.1 years and 5 were males and 3 were females. 2) Blow of site of the head were right frontal 3, left frontal 3, right parietal 1 and right temporal 1. However, hematoma in the basal ganglia occurred 6 in the left and 2 in the right. 3) On admission, the consciousness level appeared 2 cases in drowsy state(GCS 13), 3 cases in stuporous state(GCS 8,9) and 3 cases in semicomcatose state(GCS 5,7). 4) CT findings of TBGH were classified into 3 types; Type I; spotty type, Type II; moderate type and Type III : massive type. The number of patients was 4 in type I, 2 in type II and 2 in type III. 5) Neurological examination revealed contralateral hemiparesis to the hematoma in all cases(8), facial nerve palsy in 3 cases, motor aphasia in 4 cases and decerebrate rigidity in 2 cases. 6) Of all cases (8), conservative treatment were done in 5 and surgical treatment in 3. As regards the outcome of all cases (8), showed good recovery in 3, moderate disabilety in 2 and death in 3. It was concluded that the first regimen to be chosen in the management of TBGH in child was medical treatment. The patient of moderately disturbed conseionsness would be successfully managed by conservative treatment. The indication for surgery should be restricted to such cases in which the consciouness status were getting worse in spite of active conservative treatment.