Skip to main content

Advertisement

Log in

Putaminal hemorrhage: Clinical-computed tomographic correlations

  • Originals
  • Published:
Neuroradiology Aims and scope Submit manuscript

Summary

Ninety-two percent of 100 patients with putaminal hemorrhage were hypertensive. Of the eight normotensive patients, seven were substance abusers or had bilateral putaminal hemorrhages. The one other normotensive patient was less than 40 years old. The 100 hemorrhages had the following locations: 1. medial putaminal (17 cases; six were normotensive and less than 40 years old and five were substance abusers); 2. lateral putaminal extending through the external capsule (eleven cases); 3. putaminal-capsular and subcortical white matter (32 cases); 4. putaminal cerebral hemispheric (19 cases); 5. putaminal-thalamic (19 cases); 6. bilateral (two cases). A disproportionate number of black patients suffered hematoma extension to the cerebral hemispheres or thalamus (46%) compared to Caucasians (23%). Overall mortality was 20% (17 blacks and three Caucasians) and occurred in patients with hematoma extension to the thalamus or cerebral hemispheres. Contrast-enhanced CT was performed in all 100 patients and provided no additional diagnostic yield. This indicates limited use for enhanced CT in hypertensive patients with putaminal hemorrhage who have a characteristic appearance of the acute hemorrhage on the nonenhanced CT.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. McCormick WF, Rosenfield DB (1973) Massive brain hemorrhage; a review of 144 cases and an examination of their causes. Stroke 4:946–954

    Google Scholar 

  2. McKissock W, Richardson A, Taylor J (1961) Primary intracerebral hematoma: a controlled trial of surgical and conservative treatment in 180 unselected cases. Lancet II:221–226

    Google Scholar 

  3. Huckman MS, Weinberg PE, Kim KS, et al. (1970) Angiographic and clinicopathologic correlates in basal ganglionic hemorrhage. Radiology 95:79–92

    Google Scholar 

  4. Shea S, Schwartzman RJ (1975) The syndrome of medial versus lateral basal ganglionic hemorrhage. Neurology 25:871

    Google Scholar 

  5. Hier DB, Davis R, Richardson EP, et al. (1977) Hypertensive putaminal hemorrhage. Ann Neurol 1:152–159

    Google Scholar 

  6. Weisberg LA (1979) Computerized tomography in intracranial hemorrhage. Arch Neurol 36:422–426

    Google Scholar 

  7. Joint National Committee (1984) The 1984 report of the Joint National Committee on detection, evaluation and treatment of high blood pressure. Arch Int Med 144:1045–1057

    Google Scholar 

  8. Weisberg LA, Wall M (1984) Small capsular hemorrhages: clinical-computed tomographic correlations. Arch Neurol 41: 1255–1257

    Google Scholar 

  9. Weisberg LA (1984) Caudate Hemorrhage. Arch Neurol 41: 971–974

    Google Scholar 

  10. Weisberg LA (1986) Thalamic hemorrhage. Neurology 36: 1382–1386

    Google Scholar 

  11. Weisberg LA (1985) Subcortical lobar intracerebral hemorrhage: clinical-computed tomographic correlations. J Neurol Neurosurg Psychiatry 48:1078–1084

    Google Scholar 

  12. Kaneko M, Tanaka K, Shimada T, et al. (1983) Long term evaluation of ultra-early operation for hypertensive intracerebral hemorrhage in 100 cases. J Neurosurg 58:838–842

    Google Scholar 

  13. Kanno T, Sano H, Shinomiya Y, et al. (1984) Role of surgery in hypertensive intracerebral hematoma. J Neurosurg 61: 1091–1099

    Google Scholar 

  14. Marshall LF, El-Hefnawi M (1984) Spontancous intracranial hemorrhage. Semin Neurol 4:422–429

    Google Scholar 

  15. Tsementzis SA (1985) Surgical management of intracerebral hematomas. Neurosurgery 16:562–572

    Google Scholar 

  16. Fisher CM (1961) The pathogy and pathogenesis of intracerebral hemorrhage. In: Fields WS (ed) Pathogenesis and treatment of cerebrovascular disease. Thomas, Springfield, p 295

    Google Scholar 

  17. Weisberg LA (1981) Multiple spontaneous intracerebral hematomas: clinical and computed tomographic correlations. Neurology 31:897–900

    Google Scholar 

  18. McCormick WF, Schochet SS (1976) Atlas of cerebrovascular disease. Saunders, Philadelphia, p 125

    Google Scholar 

  19. Case CS, Mohr JP (1980) Supratentorial intracerebral hemorrhage in stroke. In: Barnett HJM, Mohr JP (eds) Churchill-Livingstone, New York, pp 525–548

    Google Scholar 

  20. Mizukami M, Nishijama M, Kin H (1981) Computed tomographic findings of good prognosis for hemiplegia in hypertensive putaminal hemorrhage. Stroke 12:648–652

    Google Scholar 

  21. Kelley RE, Kovacs AG (1986) Horizontal gaze paresis in hemispheric stroke. Stroke 17:1030–1032

    Google Scholar 

  22. Kelley RE, Berger JR, Scheinberg P (1982) Active bleeding in hypertensive intracerebral hemorrhage. Neurology 32:852–856

    Google Scholar 

  23. Fisher CM (1971) Pathological observations in hypertensive cerebral hemorrhage. J Neuropathol Exp Neurol 30:536–550

    Google Scholar 

  24. Russell RWR (1963) Observations on intracerebral aneurysms. Brain 86:425–442

    Google Scholar 

  25. Cole FM, Yates PO (1967) Pseudo-aneurysms in relationship to massive cerebral hemorrhage. J Neurol Neurosurg Psychiatry 30: 61–66

    Google Scholar 

  26. Cole FM, Yates PO (1967) The occurrence and significance of intracerebral micro-aneurysms. J Pathol Bacteriol 93:393–411

    Google Scholar 

  27. Cole FM, Yates P (1957) Intracerebral microaneurysms and small cerebrovascular lesions. Brain 80:759–767

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Weisberg, L.A., Stazio, A., Elliott, D. et al. Putaminal hemorrhage: Clinical-computed tomographic correlations. Neuroradiology 32, 200–206 (1990). https://doi.org/10.1007/BF00589112

Download citation

  • Received:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00589112

Key words

Navigation