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Clinical Reasoning: A 50-Year-Old Man With Intracerebral Hemorrhage and Tortuous Retinal Arterioles

Jean Bouchart1, Sacha Weber1, Thibault Coste1

  • 1From the Departments of Neurology (J.B., S.W., M.L., A.N.), Genetics (S.W.), and Ophthalmology (M-A. L.), Université Caen-Normandie, CHU de Caen-Normandie, Caen; NeuroDiderot (T.C.), Université Paris Cité, Inserm UMR 1141; and Service de Génétique Moléculaire Neurovasculaire (T.C.), AP-HP, Hôpital Saint-Louis, Paris, France.

Neurology
|August 21, 2024
PubMed

A 50-year-old man presented with headache. Examination showed left sided ataxic hemiparesis and elevated blood pressure. Brain imaging revealed an acute intracerebral hemorrhage in the right lentiform nucleus, deep and periventricular white matter hyperintensities, and predominantly deep cerebral microbleeds. Fundus examination showed important arteriolar tortuosity involving several blood vessels. In this young patient, we explain the diagnostic approach to intracerebral hemorrhage, the causes of cerebral small vessel disease, and the interpretation of biomolecular tests.

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