Minimally invasive surgery for bilateral large basal ganglia hemorrhage: a rare case report and insights from literature

Acute bilateral basal ganglia hemorrhage is a rare and life-threatening condition, often associated with high morbidity and mortality. Timely diagnosis and intervention are crucial to improving outcomes. This report presents a case successfully managed with minimally invasive surgery (MIS). A 44-year-old male, previously independent in daily activities with a medical history of hypertension, presented to the emergency department with severely altered consciousness [Glasgow Coma Scale (GCS) score 6]. Immediate intubation and admission to the intensive care unit (ICU) were initiated. Computed tomography (CT) angiography confirmed no evidence of vascular abnormalities or aneurysms. Tubular retractor-assisted microsurgical evacuation was performed to remove the hematoma and reduce intracranial pressure (ICP). The patient demonstrated neurological improvement, including spontaneous eye opening by postoperative day 3 and discharge from the ICU on day 10, highlighting the effectiveness of the intervention. He was subsequently discharged from the hospital on day 15 and transferred to a rehabilitation center for further recovery. Bilateral basal ganglia hemorrhage is rare, and its management often poses challenges due to high morbidity and mortality rates. This case underscores the importance of prompt diagnosis and intervention in bilateral basal ganglia hemorrhage. MIS offers a viable therapeutic option that may enhance recovery while reducing surgical risks.