Fax +41 61 306 12 34 E-Mail karger@karger.ch www.karger.com Original Paper Pediatr Neurosurg 2010;46:267–271 DOI: 10.1159/000321541 Outcome of Pediatric Patients with Traumatic Basal Ganglia Hematoma: Analysis of 21 Cases Nilesh S. Kurwale Deepak Kumar Gupta Ashok Kumar Mahapatra  Department of Neurosurgery and Gamma Knife, All-India Institute of Medical Sciences, New Delhi, India mission mainly determined the ultimate outcome in pediat- ric TBGH. The mode of injury or associated intracranial in- juries did not change the outcome. The presence of TBGH in severely head-injured patients worsens the prognosis and outcome. Copyright © 2010 S. Karger AG, Basel Introduction Traumatic basal ganglia hematoma (TBGH) is an un- common occurrence in head injuries, with an overall in- cidence of 3% in all closed head injuries, though in pedi- atric patients the exact incidence is still to be worked out [1]. TBGH mostly occurs in severe head injuries caused by high-velocity trauma; characteristic single or multiple hematomas or hemorrhagic contusions are observed in the region of the basal ganglia. This was earlier consid- ered as a spectrum of diffuse axonal injury; however, Ad- ams et al. [2] considered it as a distinct entity with a well- defined etiology and pathogenesis. Maki et al. [3] hypoth- esized on the possible role of shearing stretch on the lenticulo-striate perforators in the occurrence of TBGH in head trauma in the pediatric age group. Few studies analyzed the outcome in pediatric TBGH with regard to Key Words Pediatric trauma  Head injury  Traumatic basal ganglia hematoma Abstract Objectives: To analyze the outcome of a pediatric popula- tion with traumatic basal ganglia hematoma (TBGH). Meth- odology: Patients !15 years of age with TBGH were studied for mode of injury, severity of injury on admission, Glasgow coma scale (GCS) score on admission, radiology, intervention and overall outcome. Observations: Twenty-one patients (male:female = 4: 1) with a mean age of 7.2 8 3.7 years (range 0.33–15 years) were studied. High-velocity trauma (52%) fol- lowed by fall from height (38%) were the leading causes. Sev- enty-six percent of the patients had severe head injury. The mean GCS score on admission was 6.0 8 2.5 (range 3–12), while the mean GCS score of the group with severe head in- jury was 4.81 8 1.7 (range 3–7). Eleven (52.4%) patients had isolated basal ganglia hematoma while 10 (47.6%) had other associated intracranial injuries. Only 3 patients required sur- gical interventions. Eleven patients (52.4%) expired during their hospital stay. At discharge, 9 (42.9%) had a poor, non- functional outcome (Glasgow outcome scale, GOS 2, 3). Con- clusion: The severity of head injuries and GCS score on ad- Received: April 8, 2010 Accepted after revision: September 28, 2010 Published online: December 16, 2010 Dr. Deepak Kumar Gupta Department of Neurosurgery, Room No 308, Third floor Jai Prakash Narayan Apex Trauma Center, Raj Nagar New Delhi 110029 (India) Tel. +91 9811 882 710, E-Mail drdeepakgupta  @  gmail.com © 2010 S. Karger AG, Basel 1016–2291/10/0464–0267$26.00/0 Accessible online at: www.karger.com/pne