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Multiple spontaneous cerebral haemorrhages. Description of a series and review of the literature

M.A. Tejero, Á.L. Guerrero-Peral, F. Iglesias, F. Gutiérrez-Martín, J. Martín-Polo, F. Sánchez-Barranco, E. Laherrán, J.I. Martín-Serradilla [REV NEUROL 2009;48:346-348] PMID: 19319814 DOI: https://doi.org/10.33588/rn.4807.2008684

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Volumen 48 | Number 07 | Nº of views of the article 7.728 | Nº of PDF downloads 837 | Article publication date 01/04/2009

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ABSTRACT

INTRODUCTION The simultaneous occurrence of intracerebral haemorraghes in different arterial territories is an clinical event that develops in 2% to 3% of hemorrhagic strokes. Multiple risk factors have been associated with multiple intracerebral haemorraghes, but none of them are clearly defined. We reported clinical features, radiological findings, and outcome of 7 patients admitted to our department during last nine years and the diverse etiologic factors are discussed.

PATIENTS AND METHODS We retrospectively reviewed all patients with acute stroke admitted to our department during the period January 1998-February 2007. Patients with a history of traumatic brain injury or suspected hemorrhagic infarctions were excluded. We collected data concerning age, risk factors, clinical features, number and location of haematomas and outcome.

RESULTS We studied 7 patients (5 males and 2 females) Mean age was 78. The most common clinical manifestations were decreased alertness and weakness. Total number of haematomas was 20, 19 (95%) supratentorial and 15 (75%) in lobar area. One patient haemorrhage extended into the ventricular system. Three patients (43%) had hipertensive history, and in only one case was associated with oral anticoagulant (14%) and one blood dyscrasia (14%). Three patients died (43%). CONCLUSION. In our series of patients with multiple intracerebral haemorraghes, clinical and radiological findings and outcome were comparable to others previously described, but our patients were older. The advanced age and lobar localization suggest amyloid angiopathy is an important risk factor to multiple intracerebral haemorraghes. KeywordsAmyloid angiopathy Haemorrhagic stroke Hypertension Multiple cerebral haemorrhages

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Original

Multiple spontaneous cerebral haemorrhages. Description of a series and review of the literature