Occipital lobe hemorrhages; clinical-computed tomographic correlations

Area of Science:

• Neurology
• Neurosurgery
• Radiology

Background:

• Occipital hematomas are rare intracranial hemorrhages.
• Understanding their varied presentations and outcomes is crucial for patient management.

Purpose of the Study:

• To analyze the clinical presentation, radiological findings, and outcomes of 18 patients with occipital hematomas.
• To investigate the relationship between hematoma location, patient demographics, etiology, and clinical course.

Main Methods:

• Retrospective analysis of 18 patients diagnosed with occipital hematomas.
• Review of clinical data, including symptoms, neurological examination, blood pressure, and laboratory findings.
• Correlation of hematoma characteristics (location, size, extension) with etiology and patient outcomes.

Main Results:

• Medial occipital hematomas (n=6) presented with headache and homonymous hemianopsia; some were normotensive, others hypertensive.
• Lateral occipital hematomas (n=3) caused headache without neurological deficit, associated with hypertension.
• Larger, extensive hematomas (n=9) involving temporal/parietal regions and intraventricular extension had diverse etiologies (coagulopathy, SLE, endocarditis) and were normotensive.
• Clinical outcomes were favorable for medial and lateral hematomas but dependent on etiology for larger ones.
• No recurrent strokes were observed in any patient.

Conclusions:

• Occipital hematoma presentation varies with location and size.
• Hypertension is associated with smaller, lateral occipital hematomas, while larger, complex hematomas suggest underlying systemic or coagulation disorders.
• Etiological investigation is vital for extensive occipital hematomas to guide treatment and predict outcomes.