Hemorrhage of the Head of Caudate Nucleus

Samarth Singh, Romulo U Esagunde, Jose C Navarro


Introduction: Intracerebral hemorrhages involve various parts of the brain. The clinical presentation varies according to location of hemorrhage.The outcome  depends on the location and associated complications. This retrospective study aims to study the etiology, clinical presentation and outcomes of caudate hemorrhage.

Methods: We conducted a retrospective study and reviewed 379 patients of intracerebral hemorrhage admitted to Jose Reyes Memorial Medical Centre, Manila, department of Neurology over a 1-year period (July 2011-June 2012).  Diagnosis was confi rmed by CT scan. Risk factors, clinical fi ndings, neuroimaging features and outcomes were analyzed.

Results: Out of the 379 patients 4 patients had a head of caudate nucleus (CN) hemorrhge and the prevalence was 1.055%. The mean age of the four patients was 41.75 yrs. Three of them were female. The volumes of hemorrhage were 2cc, 4cc, 5cc and 12 cc. Three patients were hypertensive, the fourth patient was an arteriovenous malformation suspect. The most common presentation was headache with vomiting. One patient presented with seizure and decrease in consciousness. intraventricular extension was present in all patients and three of them had hydrocephalus on CT scan. Two of the patients expired and two were discharged.

Conclusion: Head of caudate hemorrhage is rare.  It is a mimicker of subarachnoid hemorrhage (SAH). Hypertension was the foremost factor associated with caudate hemorrhage. Poor outcomes were associated with hydrocephalus.

Keywords: Caudate hemorrhage,  Hypertension, Hydrocephalus,Intraventricular Extension(IVE) , Subarachnoid hemorrhage(SAH)

Samarth Singh, MD,
Consultant Neurologist National Institute of Neurological and allied Sciences
Kathmandu, Nepal