Multiple simultaneous intracerebral hemorrhages -: Clinical features and outcome

被引:46
作者
Mauriño, J [1 ]
Saposnik, G [1 ]
Lepera, S [1 ]
Rey, RC [1 ]
Sica, RE [1 ]
机构
[1] Univ Buenos Aires, Hosp JM Ramos Mejia, Dept Neurol, Stroke Serv, RA-1425 Buenos Aires, DF, Argentina
关键词
D O I
10.1001/archneur.58.4.629
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: The simultaneous occurrence of intracerebral hemorrhages in different arterial territories is an uncommon clinical event. Its predisposing factors and pathophysiological mechanisms are not clearly defined. Objective: To analyze the frequency, risk factors, clinical features, neuroimaging findings, and outcome of multiple simultaneous intracerebral hemorrhages (SIHs). Patients and Methods: We studied all patients with acute stroke admitted to our hospital from July 18, 1997, through December 18, 1999. Multiple SIHs were defined as the presence of 2 or more intracerebral hemorrhages affecting different arterial territories with identical computed tomographic density profiles. Patients with a history of traumatic brain injury were excluded from this study. Diagnostic investigation included routine blood and urine tests, coagulation studies, a chest radiograph, electrocardiogram, 2-dimensional transthoracic echocardiography, and computed tomography of the head without contrast medium. Disability was assessed using the National Institutes of Health Stroke Scale and Modified Rankin Scale. Results: Among 142 patients with hemorrhagic stroke, we found 4 (2.8%) with SIHs. All 4 patients had a history of uncontrolled arterial hypertension. We excluded other potential causes of multiple SIHs by using appropriate diagnostic tests. The most common clinical manifestations were headache and weakness. Localization of hematomas was supratentorial, except for one patient who had both infratentorial and supratentorial hemorrhages. The mean National Institutes of Health score an admission was 15 and the Modified Rankin Scale score was higher than 4 at 3 months. Conclusions: In our study, all patients with multiple SIHs had arterial hypertension and a poor outcome. Additional analytic studies, including new imaging techniques, can help to elucidate the association between arterial hypertension and multiple SIHs, rick factors, and underlying mechanisms of this clinical condition.
引用
收藏
页码:629 / 632
页数:4
相关论文
共 17 条
[1]   ULTRA-EARLY EVALUATION OF INTRACEREBRAL HEMORRHAGE [J].
BRODERICK, JP ;
BROTT, TG ;
TOMSICK, T ;
BARSAN, W ;
SPILKER, J .
JOURNAL OF NEUROSURGERY, 1990, 72 (02) :195-199
[2]  
Chan S, 1996, AM J NEURORADIOL, V17, P1821
[5]   CEREBRAL AMYLOID ANGIOPATHY AS A CAUSE OF MULTIPLE INTRACEREBRAL HEMORRHAGES [J].
GILLES, C ;
BRUCHER, JM ;
KHOUBESSERIAN, P ;
VANDERHAEGHEN, JJ .
NEUROLOGY, 1984, 34 (06) :730-735
[6]  
Guerrero A L, 1997, Neurologia, V12, P320
[7]   MULTIPLE SIMULTANEOUS INTRACEREBRAL HEMATOMAS - CLINICAL, RADIOLOGIC, AND PATHOLOGIC FINDINGS IN 2 PATIENTS [J].
HICKEY, WF ;
KING, RB ;
WANG, AM ;
SAMUELS, MA .
ARCHIVES OF NEUROLOGY, 1983, 40 (08) :519-522
[8]  
KOMIYAMA M, 1995, NEURORADIOLOGY, V37, P129
[9]   Silent intracerebral microhemorrhages in patients with ischemic stroke [J].
Kwa, VIH ;
Franke, CL ;
Verbeeten, B ;
Stam, J .
ANNALS OF NEUROLOGY, 1998, 44 (03) :372-377
[10]   MASSIVE BRAIN HEMORRHAGE - REVIEW OF 144 CASES AND AN EXAMINATION OF THEIR CAUSES [J].
MCCORMICK, WF ;
ROSENFIELD, DB .
STROKE, 1973, 4 (06) :946-954