Hypotensive hemorrhagic necrosis in basal ganglia and brainstem

Hypotensive hemorrhagic necrosis of the basal ganglia and brainstem has onl y occasionally been described. Three such cases are reported. Cardiac arres t had occurred in all cases, and it took at least 1 hour to restore adequat e circulation. The patients remained comatose for 2 days to 2 weeks until d eath. Persistent hypotension causing ischemia in the distribution of deep p erforating arteries is considered to have been the key underlying mechanism . Hemorrhage is thought to have been caused by extravasation of red blood c ells through damaged blood vessels.