Recurrent, sequential, bilateral deep cerebellar hemorrhages: a case report

Area of Science:

• Neurology
• Neurosurgery
• Vascular Neurology

Background:

• Hypertensive intracerebral hemorrhage is typically a singular event.
• Recurrences are uncommon and often linked to sustained hypertension.
• Hemorrhage sites are usually basal ganglia and thalami.

Purpose of the Study:

• To report a rare case of recurrent hypertensive cerebral hemorrhage.
• To highlight the occurrence of sequential bilateral cerebellar hemorrhages.
• To discuss the implications for patients with hypertension.

Main Methods:

• Case report of a 59-year-old female patient.
• Detailed clinical presentation and imaging findings.
• Follow-up on patient's functional recovery.

Main Results:

• The patient experienced two sequential deep cerebellar hemorrhages (right then left).
• The hemorrhages occurred 57 days apart, with blood pressure well-controlled.
• Magnetic resonance angiogram was unremarkable.
• The patient achieved a good functional recovery despite the critical location and short interval.

Conclusions:

• Recurrent hypertensive hemorrhage is rare, typically occurring within two years of the initial event.
• This is the first reported case of bilateral, sequential deep cerebellar hemorrhages.
• Hypertension remains the presumed etiology, even with controlled blood pressure.