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Multiple Simultaneous Spontaneous Intracerebral Hemorrhages: A Rare Entity
Yaohua Chen1, Hilde Hénon, Stéphanie Bombois
1Department of Neurology, University of Lille, UDSL, CHU Lille, INSERM U 1171, Lille, France.
Cerebrovascular Diseases (Basel, Switzerland)
|December 17, 2015
Summary
Multiple simultaneous intracerebral hemorrhages (ICH-m) are rare but severe. Long-term outcomes show very low survival rates, with survivors often experiencing seizures and new brain bleeds, especially those with cerebral amyloid angiopathy (CAA).
Area of Science:
- Neurology
- Neurosurgery
- Vascular Neurology
Background:
- Multiple simultaneous intracerebral hemorrhages (ICH-m) represent a rare subtype of ICH, accounting for 0.7-5.6% of all cases.
- The long-term prognosis and outcomes of patients experiencing ICH-m have not been systematically investigated prospectively.
Purpose of the Study:
- To determine the long-term outcome and survival rates for patients diagnosed with multiple simultaneous intracerebral hemorrhages (ICH-m).
Main Methods:
- A prospective cohort study involving consecutive adult patients diagnosed with ICH-m.
- Patients were followed for a minimum of 4.5 years.
- Classification into etiological groups: probable cerebral amyloid angiopathy (CAA), deep perforating vasculopathy (DPV), and unknown causes.
Main Results:
- Out of 562 ICH patients, 32 (5.7%) had ICH-m, categorized as probable CAA (8), DPV (5), or undetermined cause (19).
- After a cumulative follow-up of 39.5 person-years, 84% of patients had died; 3 of the 5 survivors achieved independence.
- Late-onset seizures, recurrent ICH-m, and new microbleeds were predominantly observed in patients with probable CAA.
Conclusions:
- ICH-m is a rare but highly severe form of intracerebral hemorrhage with a poor long-term prognosis.
- Survivors, particularly those with CAA, face increased risks of late-onset seizures and additional hemorrhagic lesions.
- Further large-scale multicenter studies are essential to enhance understanding of this rare condition due to low survival rates.
