A case of spontaneous basal ganglia hemorrhage with contralateral extension utilizing the canal of Gratiolet

BMC Neurol. 2023 May 12;23(1):190. doi: 10.1186/s12883-023-03232-4.


Background: Intracranial hemorrhage accounts for 10-20% of stroke etiologies annually. Basal ganglia is the most common site for intracranial hemorrhage accounting for 50% of all cases. Bilateral spontaneous basal ganglia hemorrhages (BGH) are rare with few reported cases.

Case presentation: We report an unusual case of a 69-year-old female who presented with a spontaneous bilateral basal ganglia hemorrhage secondary to a right BGH with contralateral extension through the anterior commissure (AC) utilizing the Canal of Gratiolet. Clinical course and imaging findings are discussed.

Conclusions: To our knowledge, this is the first case to specifically detail the extension of spontaneous hemorrhage across the AC via the Canal of Gratiolet, and imaging findings provide a novel depiction of AC anatomy and fiber distribution in a clinical context. These findings may explain the mechanism behind this rare clinical entity.

Keywords: Anterior commissure; Bilateral basal ganglia hemorrhage; Canal of Gratoilet; Case report; Hemorrhagic stroke.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Basal Ganglia / diagnostic imaging
  • Basal Ganglia Hemorrhage* / complications
  • Basal Ganglia Hemorrhage* / diagnostic imaging
  • Female
  • Humans
  • Intracranial Hemorrhages / complications
  • Intracranial Hemorrhages / diagnostic imaging
  • Stroke* / complications