Skip to main content
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1986 Sep;49(9):1039–1043. doi: 10.1136/jnnp.49.9.1039

Deep intracerebral (basal ganglia) haematomas in fatal non-missile head injury in man.

J H Adams, D Doyle, D I Graham, A E Lawrence, D R McLellan
PMCID: PMC1029009  PMID: 3760892

Abstract

Deep intracerebral (basal ganglia) haematomas were found post mortem in 63 of 635 fatal non-missile head injuries. In patients with a basal ganglia haematoma, contusions were more severe, there was a reduced incidence of a lucid interval, and there was an increased incidence of road traffic accidents, gliding contusions and diffuse axonal injury than in patients without this type of haematoma. Intracranial haematoma is usually thought to be a secondary event, that is a complication of the original injury, but these results suggest that a deep intracerebral haematoma is a primary event. If a deep intracerebral haematoma is identified on an early CT scan it is likely that the patient has sustained severe diffuse brain damage at the time of injury. In the majority of head injuries damage to blood vessels or axons predominates. In patients with a traumatic deep intracerebral haematoma, it would appear that the deceleration/acceleration forces are such that both axons and blood vessels within the brain are damaged at the time of injury.

Full text

PDF
1039

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adams J. H., Doyle D., Graham D. I., Lawrence A. E., McLellan D. R. Diffuse axonal injury in head injuries caused by a fall. Lancet. 1984 Dec 22;2(8417-8418):1420–1422. doi: 10.1016/s0140-6736(84)91620-9. [DOI] [PubMed] [Google Scholar]
  2. Adams J. H., Doyle D., Graham D. I., Lawrence A. E., McLellan D. R., Gennarelli T. A., Pastuszko M., Sakamoto T. The contusion index: a reappraisal in human and experimental non-missile head injury. Neuropathol Appl Neurobiol. 1985 Jul-Aug;11(4):299–308. doi: 10.1111/j.1365-2990.1985.tb00027.x. [DOI] [PubMed] [Google Scholar]
  3. Adams J. H., Doyle D., Graham D. I., Lawrence A. E., McLellan D. R. Microscopic diffuse axonal injury in cases of head injury. Med Sci Law. 1985 Oct;25(4):265–269. doi: 10.1177/002580248502500407. [DOI] [PubMed] [Google Scholar]
  4. Adams J. H., Graham D. I., Gennarelli T. A. Head injury in man and experimental animals: neuropathology. Acta Neurochir Suppl (Wien) 1983;32:15–30. doi: 10.1007/978-3-7091-4147-2_2. [DOI] [PubMed] [Google Scholar]
  5. Adams J. H., Graham D. I., Murray L. S., Scott G. Diffuse axonal injury due to nonmissile head injury in humans: an analysis of 45 cases. Ann Neurol. 1982 Dec;12(6):557–563. doi: 10.1002/ana.410120610. [DOI] [PubMed] [Google Scholar]
  6. Gennarelli T. A. Head injury in man and experimental animals: clinical aspects. Acta Neurochir Suppl (Wien) 1983;32:1–13. doi: 10.1007/978-3-7091-4147-2_1. [DOI] [PubMed] [Google Scholar]
  7. Gennarelli T. A., Spielman G. M., Langfitt T. W., Gildenberg P. L., Harrington T., Jane J. A., Marshall L. F., Miller J. D., Pitts L. H. Influence of the type of intracranial lesion on outcome from severe head injury. J Neurosurg. 1982 Jan;56(1):26–32. doi: 10.3171/jns.1982.56.1.0026. [DOI] [PubMed] [Google Scholar]
  8. Gennarelli T. A., Thibault L. E., Adams J. H., Graham D. I., Thompson C. J., Marcincin R. P. Diffuse axonal injury and traumatic coma in the primate. Ann Neurol. 1982 Dec;12(6):564–574. doi: 10.1002/ana.410120611. [DOI] [PubMed] [Google Scholar]
  9. Graham D. I., Adams J. H., Doyle D. Ischaemic brain damage in fatal non-missile head injuries. J Neurol Sci. 1978 Dec;39(2-3):213–234. doi: 10.1016/0022-510x(78)90124-7. [DOI] [PubMed] [Google Scholar]
  10. Graham D. I., McLellan D., Adams J. H., Doyle D., Kerr A., Murray L. S. The neuropathology of the vegetative state and severe disability after non-missile head injury. Acta Neurochir Suppl (Wien) 1983;32:65–67. doi: 10.1007/978-3-7091-4147-2_6. [DOI] [PubMed] [Google Scholar]
  11. MOSBERG W. H., LINDENBERG R. Traumatic hemorrhage from the anterior choroidal artery. J Neurosurg. 1959 Mar;16(2):209–221. doi: 10.3171/jns.1959.16.2.0209. [DOI] [PubMed] [Google Scholar]
  12. Macpherson P., Teasdale E., Dhaker S., Allerdyce G., Galbraith S. The significance of traumatic haematoma in the region of the basal ganglia. J Neurol Neurosurg Psychiatry. 1986 Jan;49(1):29–34. doi: 10.1136/jnnp.49.1.29. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Reilly P. L., Graham D. I., Adams J. H., Jennett B. Patients with head injury who talk and die. Lancet. 1975 Aug 30;2(7931):375–377. doi: 10.1016/s0140-6736(75)92893-7. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES