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Caudate hemorrhage, often linked to hypertension or arteriovenous malformations (AVMs), presents similar symptoms. Conservative treatment for hypertensive cases and AVM resection show positive outcomes.
Area of Science:
- Neurology
- Neurosurgery
- Vascular Neurology
Background:
- Caudate nucleus hemorrhages are rare cerebrovascular events.
- Understanding the etiology and clinical presentation is crucial for effective management.
Observation:
- Thirteen patients with caudate hemorrhages were analyzed.
- Hemorrhages occurred in the caudate nucleus head, often extending into the lateral ventricle.
- Two primary causes identified: hypertension (9 patients, older) and arteriovenous malformations (AVMs) (4 patients, younger).
Findings:
- Clinical manifestations were similar across both etiological groups, frequently mimicking subarachnoid hemorrhage and presenting with hemiparesis.
- Hypertension-related hemorrhages showed good recovery with conservative management.
- Arteriovenous malformation ruptures were successfully treated with resection via an anterior transcallosal approach.
Implications:
- Caudate hemorrhages require prompt diagnosis and tailored treatment strategies based on etiology.
- Conservative management is effective for hypertensive caudate hemorrhages.
- Surgical resection of AVMs offers a safe and recommended treatment option for related caudate hemorrhages.
Abstract:
Thirteen patients with caudate hemorrhage are described. All the hemorrhages were in the head of the caudate nucleus, and all the hemorrhages but one ruptured in the anterior horn of the lateral ventricle. In 9 patients, the hemorrhage was related to hypertension and the patients were older. In the other 4 patients, the hemorrhage resulted from rupture of an arteriovenous malformation (AVM) and the patients were under 40 years old. Clinical manifestations were nearly the same in both groups, suggestive of subarachnoid hemorrhage and including hemiparesis in most patients. In patients with hypertension, good recovery was obtained by conservative treatment and in those with ruptured AVMs, resection of AVMs through an anterior transcallosal approach may be safe and recommended.