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Multiple simultaneous intracerebral hemorrhages: clinical features and outcome
J Mauriño1, G Saposnik, S Lepera
1Department of Neurology, Hospital J. M. Ramos Mejía, Soler 4019, Sexto Piso, Buenos Aires 1425, Argentina. jorgemaurino@hotmail.com
Archives of Neurology
|May 1, 2001
Summary
Multiple simultaneous intracerebral hemorrhages (SIHs) are rare but strongly linked to uncontrolled arterial hypertension. These patients often experience poor outcomes, highlighting the need for further research into SIHs.
Area of Science:
- Neurology
- Vascular Neurology
- Neurocritical Care
Background:
- Simultaneous intracerebral hemorrhages (SIHs) in distinct arterial territories are uncommon.
- Predisposing factors and pathophysiological mechanisms for SIHs remain unclear.
Purpose of the Study:
- To investigate the frequency, risk factors, clinical presentation, neuroimaging, and outcomes of multiple SIHs.
- To identify potential associations between SIHs and patient characteristics.
Main Methods:
- Retrospective analysis of acute stroke patients admitted between July 1997 and December 1999.
- Defined SIHs as ≥2 hemorrhages in different arterial territories with similar CT density.
- Excluded traumatic brain injury; comprehensive diagnostic workup and validated stroke scales (NIHSS, mRS) were employed.
Main Results:
- Identified 4 cases (2.8%) of SIHs among 142 hemorrhagic stroke patients.
- All SIH patients presented with uncontrolled arterial hypertension.
- Common symptoms included headache and weakness; most hematomas were supratentorial, and outcomes were poor (NIHSS 15, mRS >4 at 3 months).
Conclusions:
- Uncontrolled arterial hypertension is a significant finding in patients with multiple SIHs.
- Multiple SIHs are associated with poor neurological outcomes.
- Further research using advanced imaging is warranted to clarify the mechanisms and risk factors for SIHs.