OVERVIEW
OVERVIEW
A basal ganglia hematoma is an injury to a functional area of the brain. There are two types: simple basal ganglia hematomas and complex basal ganglia hematomas, which are combined with other intracranial hematomas and have a poorer prognosis.
Whether medical insurance
yes
Department
Neurology, Neurosurgery
Synonyms
Basal edema, Basal ganglia hemorrhage
Clinical Symptoms
Early onset of complete hemiparesis with relatively mild impairment of consciousness. If combined with other intracranial edema, there is more severe impairment of consciousness and hemiparesis.
Hazards
Complete hemiparesis and impaired consciousness in a short period of time, can also be combined with other intracranial edema, the condition deteriorates rapidly and can be life-threatening.
Complications
Cerebral edema
Examination
CT of the head.
Diagnosis
The diagnosis can be made on the basis of the patient’s history of hypertension, acute onset, early clinical manifestations such as complete hemiparesis and impaired consciousness, combined with cranial CT examination. Patients with post-traumatic basal ganglia hematoma have a history of trauma.
Treatment principle
Depending on the condition, palliative treatment or early surgical treatment can be given to remove the hematoma.
Curable
Simple basal ganglia hematoma generally has a good therapeutic effect, while compound basal ganglia hematoma has a poorer prognosis.
Dietary advice
1. Gastric tube feeding or parenteral nutritional support can be given to those with impaired consciousness. 2. Light, high protein, high calorie and high vitamin diet should be given after discharge from the hospital to enhance nutrition and promote recovery.
Etiology
Etiology
Generally caused by hypertension, partly caused by head trauma.
Symptoms and Diagnosis
Typical Symptoms
Early onset of complete hemiparesis with relatively mild impairment of consciousness. If combined with other intracranial edema, there is more severe impaired consciousness and hemiparesis.
Diagnostic basis
The patient presents with clinical manifestations of complete hemiparesis and impaired consciousness at an early stage. Combined with cranial CT examination, the diagnosis can be confirmed by the presence of a high-density mass in the basal ganglia region.
Treatment
Treatment guideline
Depending on the condition of the patient, palliative treatment or early surgical treatment can be given to remove the hematoma.
Surgical treatment
Generally speaking, if the hematoma volume is more than 25 ml, surgery should be performed to remove the hematoma in time. However, the indications for surgery can be appropriately relaxed in the light of the clinical condition, especially when combined with cerebral swelling and cerebral edema. For simple basal ganglia hematoma, drilling and puncture drainage can be used; if simple basal ganglia hematoma has broken into the ventricle, direct ventricular puncture can be performed to place a catheter for drainage; for compound basal ganglia hematoma, craniotomy is usually needed to remove the compound edema, and stop the bleeding completely.
Other treatments
If the patient’s consciousness improves after the injury, the hematoma is less than 30 ml, the intracranial pressure does not exceed 3.33 kPa (25 mmHg), CT shows no serious compression of the ventricles and cerebral pools, the midline shift does not exceed 10 mm, and the ventricles have not been penetrated, palliative treatment is feasible.
Prognosis
Simple basal ganglia hematoma generally has a good treatment outcome, and compound basal ganglia hematoma has a poorer prognosis.
Nursing care
Daily care
Closely observe the patient’s recovery, and consult the doctor promptly if hemiplegia, consciousness disorder and other abnormal manifestations occur again. Pay attention to rest, avoid exertion, maintain a happy mood and avoid mental stimulation.
Dietary management
1. Gastric tube feeding or parenteral nutritional support can be given to those with impaired consciousness. 2. Light, high protein, high calorie and high vitamin diet should be given after discharge from the hospital to strengthen nutrition and promote recovery. 3.