STROKE:
Basal Ganglia Bleed
Anatomy Of The Basal Ganglia
• Basal ganglia is located deep with each of cerebral hemisphere in the
telencephalon region of the brain.
• The components of the basal ganglia are:
1. The Caudate,
2. The Putamen
3. The Globus Pallidus,
4. The Subthalamic Nucleus
5. The Substantia Nigra
The basal ganglia receive input from the cerebral cortex and provide
output back to motor areas of the cerebralcortex via neural
connection with nuclei of the thalamus.
Major function of the basal ganglia:
i. Suppres unwanted movements
ii. Help initiate and terminate movements of the body
iii. Regulate muscle tone
The basal ganglia also influence many aspects of cortical function
such as sensory, limbic, cognitive and linguistic function.
Basal Ganglia Haemorrhage (bleeding)
• A basal ganglia haemorrhage is bleeding from blood
vessels in an area of the brain that responsible for the
body movements, sensation, speech and personality.
• The area of the basal ganglia is the part of the brain
most frequently affected by haemorrhages.
• A brain haemorrhage causes blood to accumulate
inside the brain, compressing and damaging brain
tissue.
• Usually artery in the basal ganglia bursts after being
damaged due to high blood pressure.
Pathophysiology Of the Stroke due to Basal
Ganglia Bleed
Presipitating factor: Predisposing factors:
Hypertantion i. Sedentary lifestyle
ii. Diet
iii. Age
iv. Sex
Vasoconstriction v. Heredity
vi. Self-medication
Blockage of the blood
vessels
Lack of oxygen and
nutrient supply
Altered and
decreased
Intracerebral haemorrhage Blood clot formation
(bleeding)
Blood irritates the nerves Pressure and brain compression
and the tissues
• Changes in movements
(ataxia)
Pain and vomiting; parts • Muscle weakness (difficulty in
of the brain will shut swallowing, smiling and
down; decreased LOC talking)
• Decreased cognitive function
• Headache, nausea and
vomiting
• Personality changes: change
in judgement, confused,
difficulty in understanding
what is happening around.
Inappropriate emotional
responses
Clinical presentation of the stroke due
to the basal ganglia bleed
I. Changes in the body movement: III. Unconsciousness, nausea, vomiting
• Rigid, stiff movements
and headache
• Movement loss
• Tremors IV. Personality Changes:
• Ataxia • Difficulty understanding
• Difficulty swallowing • Frustation
• Difficulty in smiling or speaking • Anxious
II. Cognitive impairment: • Lack of motivation
• Ability to make decisions • Loss of interest in any activities
• Memory • Crying for no reason
• Language • Laugh for no reason
• Attantion • Depression
• Anger
Doctor and Physiotherapist Management
for the stroke due to basal ganglia bleed
1. Brain imaging – CT scan ca.n show fresh blood in the skull.
2. Pain medication,
3. Stabilizing vital signs,
4. Pressure inside the head.
5. Surgery to removing any blood to relieve pressure,
6. A shunt operation to drain the system
i. Strengthening and exercise
ii. Passive (PROM) and active (AROM) exercise
iii. Improving balance and mobility
iv. Balance and sensory organization
v. Locomotor training
vi. Adative equipment: walking aids, wheelchair
[Link] training
References
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victims/
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11. [Link]
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