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Delayed Consecutive Contralateral Thalamic Hemorrhage after Spontaneous Thalamic Hemorrhage.
Ji Hun Han1, Jin Pyeong Jeon1, Hyuk Jai Choi1
1Department of Neurosurgery, Hallym University College of Medicine, Chuncheon, Korea.
Journal of Cerebrovascular and Endovascular Neurosurgery
|October 30, 2016
Summary
This study details the first reported case of delayed consecutive contralateral thalamic hemorrhage occurring 17 days after the initial event. It underscores the importance of monitoring patients with thalamic hemorrhage for potential delayed bleeding.
Area of Science:
- Neurology
- Neurosurgery
- Radiology
Background:
- Bilateral thalamic hemorrhages are uncommon, with previous reports showing a time lag of up to two days between events.
- Spontaneous thalamic hemorrhage requires careful management and monitoring due to potential complications.
Observation:
- A 65-year-old female presented with right thalamic and intraventricular hemorrhage, initially improving with medical management.
- Seventeen days post-initial hemorrhage, the patient experienced a seizure and subsequent CT scans revealed a new contralateral thalamic hemorrhage with microbleeds.
Findings:
- This case represents the first documented instance of delayed (17 days) consecutive contralateral thalamic hemorrhage.
- The new hemorrhage occurred in the absence of further acute injury or intervention, suggesting a delayed pathological process.
Implications:
- The findings highlight the potential for delayed contralateral thalamic hemorrhage in patients with initial thalamic bleeds, especially when microbleeds are present.
- Close neurological monitoring is crucial for patients with thalamic hemorrhage, particularly if contralateral microbleeds are detected, to anticipate and manage delayed hemorrhagic events.
