Yadav Pramodman Singh, Panthi Sagar, Neupane Aakash, Uprety Manish, Acharya Rochana, Shah Leeza, Ansari Ajmat, Basnet Ujjwal, Bhattarai Raksha, Khanal Bhawani
Department of Internal Medicine, B.P. Koirala Institute of Health Sciences.
Kathmandu University School of Medical Science, Dhulikhel, Nepal.
Ann Med Surg (Lond). 2023 Apr 6;85(5):1830-1833. doi: 10.1097/MS9.0000000000000103. eCollection 2023 May.
Spontaneous bilateral intracerebral haemorrhage is a rare surgical occurrence, especially in young populations with poor prognosis. Hypertension is the leading cause but vascular malformations, infections and rare genetic conditions are also responsible.
Twenty-three-year-old male with no prior comorbidities presented to emergency with sudden onset loss of consciousness and 1 episode of seizure. No history of intoxication or trauma was given. Glasgow Coma Scale at presentation was E1V2M2. CT scan head revealed bilateral basal ganglia haematoma along intraventricular haemorrhage.
The patient was managed conservatively in the Neurosurgical Intensive care unit. Supportive management was provided. The patient's motor response was improving and a repeat CT scan showed a resolving haematoma. However, due to poor economic conditions, the patient party left against medical advice.
Spontaneous bilateral basal ganglia haemorrhage is a rare surgical emergency with no clear consensus on a management approach. This case highlights the importance of undiagnosed hypertension in causing intracerebral haemorrhage in poor economic groups.
自发性双侧脑出血是一种罕见的外科病症，尤其是在预后较差的年轻人群中。高血压是主要病因，但血管畸形、感染和罕见的遗传疾病也有责任。
一名23岁无既往合并症的男性因突发意识丧失和1次癫痫发作就诊于急诊科。无中毒或外伤史。就诊时格拉斯哥昏迷量表评分为E1V2M2。头颅CT扫描显示双侧基底节血肿伴脑室内出血。
患者在神经外科重症监护病房接受保守治疗。给予支持性治疗。患者的运动反应有所改善，复查CT扫描显示血肿正在吸收。然而，由于经济条件差，患者家属违背医嘱离院。
自发性双侧基底节脑出血是一种罕见的外科急症，对于治疗方法尚无明确共识。本病例强调了在经济条件差的群体中，未诊断出的高血压在导致脑出血方面的重要性。
