Bilateral basal ganglia hemorrhage: a systematic review of etiologies, management strategies, and clinical outcomes

Abstract Bilateral basal ganglia hemorrhages (BBGHs) represent rare accidents, with no clear standard of care currently defined. We reviewed the literature on BBGHs and analyzed the available conservative and surgical strategies. PubMed, Scopus, Web of Science, and Cochrane were searched following the PRISMA guidelines to include studies reporting patients with BBGHs. Clinical characteristics, management, and outcomes were analyzed. We included 64 studies comprising 75 patients, 25 (33%) traumatic and 50 (67%) non-traumatic. Traumatic cases affected younger patients (mean age 35 vs. 46 years, p=0.014) and males (84% vs. 71%, p=0.27) and were characterized by higher proportion of normal blood pressures at admission (66% vs. 13%, p=0.0016) compared to non-traumatic cases. Most patients were comatose at admission (56%), with a mean Glasgow Coma Scale (GCS) score of 7 and a higher proportion of comatose patients in the traumatic than in the non-traumatic group (64% vs. 52%, p=0.28). Among the traumatic group, motor vehicle accidents and falls accounted for 79% of cases. In the non-traumatic group, hemorrhage was most associated with hypertensive or ischemic (54%) and chemical (28%) etiologies. Management was predominantly conservative (83%). Outcomes were poor in 56% of patients with mean follow-up of 8 months. Good recovery was significantly higher in the traumatic than in the non-traumatic group (48% vs. 17%, p=0.019). BBGHs are rare occurrences with dismal prognoses. Standard management follows that of current intracerebral hemorrhage guidelines with supportive care and early blood pressure management. Minimally invasive surgery is promising, though substantial evidence is required to outweigh the potentially increased risks of bilateral hematoma evacuation..

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:46

Enthalten in:

Neurosurgical review - 46(2023), 1 vom: 05. Juni

Sprache:

Englisch

Beteiligte Personen:

Watanabe, Gina [VerfasserIn]
Conching, Andie [VerfasserIn]
Ogasawara, Christian [VerfasserIn]
Chavda, Vishal [VerfasserIn]
Bin-Alamer, Othman [VerfasserIn]
Haider, Ali S. [VerfasserIn]
Priola, Stefano M. [VerfasserIn]
Sharma, Mayur [VerfasserIn]
Hoz, Samer S. [VerfasserIn]
Chaurasia, Bipin [VerfasserIn]
Umana, Giuseppe E. [VerfasserIn]
Palmisciano, Paolo [VerfasserIn]

Links:

Volltext [lizenzpflichtig]

Themen:

Basal ganglia
Head trauma
Hematoma evacuation
Intracerebral hemorrhage
Neurointensive care management

Anmerkungen:

© The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

doi:

10.1007/s10143-023-02044-x

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

OLC2143693184

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