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[Specular bilateral lenticular hematomas]
A 49-year-old right-handed hypertensive female developed two consecutive putaminal hemorrhages in the left and right hemispheres within one month. Recurrent specular hypertensive hematomas are rare, even though the underlying pathological changes in the arterial wall occur bilaterally. This may be explained by the spontaneous decrease in blood pressure occurring in patients after an acute stroke. In this patient, a new abrupt increase in blood pressure may account for the second hemorrhage. While lowering the blood pressure during an acute stroke may be in principle unadvisable, it seems reasonable to prevent a new increase in blood pressure with adequate therapy.
A 49-year-old right-handed hypertensive female developed two consecutive putaminal hemorrhages in the left and right hemispheres within one month. Recurrent specular hypertensive hematomas are rare, even though the underlying pathological changes in the arterial wall occur bilaterally. This may be explained by the spontaneous decrease in blood pressure occurring in patients after an acute stroke. In this patient, a new abrupt increase in blood pressure may account for the second hemorrhage. While lowering the blood pressure during an acute stroke may be in principle unadvisable, it seems reasonable to prevent a new increase in blood pressure with adequate therapy.