Spontaneous hemorrhage in previously ischemic (pale) cerebral infarcts

Spontaneous bleeding into a pale cerebral infarct is documented in 2 patients. Neither patient had received anticoagulants or was hypertensive. The development of the hemorrhage was associated with neurological worsening. Initial CT scans showed a hypodense lesion in an arterial distribution representing infarction; subsequent CT scans showed multiple areas of hemorrhage within the hypodense lesion. The size of the hemorrhages and their location in gray and white matter differ from the pattern of hemorrhagic infarction and primary intracerebral hemorrhage as visualized on CT scan and at autopsy.