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[Simultaneous, bilateral hypertensive intracranial hematomas].

T Tanikake, S Kawaguchi, T Tada

    No Shinkei Geka. Neurological Surgery
    |October 1, 1983
    PubMed
    Summary
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    Bilateral intracerebral hemorrhages from hypertension are rare in Japan. This study presents two cases, highlighting neurological signs and discussing potential causes like microaneurysm rupture or circulatory disturbances.

    Area of Science:

    • Neurology
    • Neurosurgery

    Background:

    • Systemic arterial hypertension is a known cause of intracerebral hemorrhage.
    • Bilateral intracerebral hemorrhages are exceptionally rare in Japan, unlike unilateral cases.

    Observation:

    • Two patients with bilateral intracerebral hemorrhages due to hypertension were examined.
    • Case 1: Bilateral thalamic hemorrhages. Case 2: Contralateral hemorrhage developed postoperatively after primary hematoma evacuation.

    Findings:

    • Characteristic neurological manifestations include quadriparesis, bilateral Babinski's signs, stupor, and coma.
    • The basal ganglia are frequently involved in hypertensive intracerebral hemorrhages.
    • Pathomechanisms may involve symmetrical microaneurysm rupture or a primary unilateral bleed followed by contralateral hemorrhage due to circulatory disturbance.

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    Implications:

    • Understanding the rare occurrence and potential mechanisms of bilateral hypertensive intracerebral hemorrhages is crucial for diagnosis.
    • Craniotomy is a potential surgical intervention for hypertensive bilateral intracerebral hemorrhage, similar to general cerebral hemorrhage cases.