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Medicine

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Neurology

Question
8 out of 27
 

Which of the following is the most common location of hypertensive hemorrhage? (AIIMS May 2012)



A Pons
B Thalamus

C Putamen
D Subcortical white matter

Ans. C

Putamen

Important Points

1). Most common site is in the territory of middle cerebral artery.

2). Most common site of atherosclerosis that leads to stroke origin of internal carotid artery within 2 cm & post. wall.

3). Most common site – Putamen

Hypertensive Hemorrhage

1). Intraparenchymal ( Ref. Hariypertensive)

a. Basal ganglia (Putamen)

b. Thalamus

c. Cerebellum

d. Pons.

2). Subarachnoid Junction of anterior communicating artery with ant cerebral artery.

(Most common cause of SAH is trauma (FAQ)

The focal neurological signs vary according to the site of the hemorrhage

Intraparenchymal bleed

1). Basal ganglia: (Putamen)

a. Arteries involved - Medial & lateral striate branches of Middle cerebral artery

b. Manifestations

i. Contralateral hemiparesis is the sentinel sign

ii. When haemorrhage is large, signs of brainstem compression may appear

2). Thalamus

a. Arteries involved - Perforating branches of posterior cerebral artery

b. Manifestations

i. Hemisensory loss involving all modalities

ii. Contralateral pain syndrome during recovery period (Desserine -Roussy syndrome)

iii. Several typical ocular disturbances:


• Down & inward deviation of eyes

• Unequal pupils with loss of light reflex

• Skew deviation with eye opp. hemorrhage deviated down and medially

• I/L Horner’s syndrome

• Absence of convergence

• Paralysis of vertical gaze

• Retraction nystagmus


Neurology Flashcard List

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