Multiple spontaneous intracerebral hematomas: clinical and computed tomographic correlations

Multiple spontaneous intracerebral hemorrhages without an identifiable etiology were diagnosed by computed tomography (CT) in 12 patients. This represented 2% of all intracranial hemorrhages. Eight were supratentorial hemispheric in location, two were hemispheric and ganglionic, one was thalamic and cerebellar, and one was bilateral cerebellar. Only two patients had a history of arterial hypertension. Five patients had no lateralizing neurologic signs, and presented with headache, altered mentation, and nuchal rigidity. The diagnosis of multiple lesions was established by CT; in only one case did angiographic findings suggest multiple lesions, and other diagnostic studies were consistent with a single lesion. In 11 cases, CT density profiles were identical, implying that the hematomas were of similar age. In the other case, CT showed one high-density nonenhancing hematoma and a second ring-enhancing lesion.