J Cerebrovasc Endovasc Neurosurg.  2016 Sep;18(3):286-290. 10.7461/jcen.2016.18.3.286.

Multiple Spontaneous Intracerebral Hematoma without Presenting Risk Factors

• Park S
• Park EK
• Kim JS
• Shim KW

• KMID: 2355656
• DOI: http://doi.org/10.7461/jcen.2016.18.3.286

Abstract

The incidence of intracerebral hemorrhage in those aged 45-84 years is 0.3-0.5%. In people over 80 years of age, this incidence increases 25-fold compared with that of the total population. The most common causes of spontaneous intracerebral hemorrhage in the younger population are vascular malformation, aneurysm, and overuse of drugs. In contrast, common causes in the elderly include hypertension, tumors, and coagulation disorders. Here, we present a case involving a 72-year-old male patient who, without any of these predisposing conditions, was admitted to the hospital with spontaneous intracerebral hemorrhage and showed signs of multifocal intracerebral hemorrhage during his stay. We conclude that spontaneous intracerebral hemorrhage can occur without any predisposing factors, and can lead to a patient's death. Therefore, the possibility of recurrent spontaneous intracerebral hemorrhage must be considered in patients with primary spontaneous intracerebral hemorrhage.

Keyword

Anticardiolipin antibodies; Autoimmune disease; Intracerebral hemorrhage

MeSH Terms

Aged
Aneurysm
Antibodies, Anticardiolipin
Autoimmune Diseases
Causality
Cerebral Hemorrhage
Hematoma*
Humans
Hypertension
Incidence
Male
Risk Factors*
Vascular Malformations
Antibodies, Anticardiolipin

Figure

• 

  Fig. 1 CT scans of the three hemorrhages. (A) the first hemorrhage in the right frontal cortex. (B) the second hemorrhage in the septum pellucidum, which occurred 7 days after the first hemorrhage. (C) the third hemorrhage in the left fronto-parietal cortex, which occurred 17 days after the second hemorrhage. CT = computed tomography.

• 

  Fig. 2 Brain CT angiography revealed no specific lesions of vascular origin (A, B). CT = computed tomography.

• 

  Fig. 3 Fragmented brain tissue with hemorrhage (× 200). No other interesting outcomes were discovered.

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