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Multiple spontaneous intracerebral hematomas

Clinical and computed tomographic correlations

Department of Psychiatry & Neurology, Tulane Medical School, and the Department of Neurology, Charity Hospital, New Orleans, LA.

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.

Address correspondence and reprint requests to Dr. Weisberg, Department of psychiatry & Neurology, Tulane Medical Center, 1415 Tulane Avenue, New Orleans, LA 70112.

Accepted for publication September 29, 1980.

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