Abstract
We describe a 62-year-old male with four episodes of intracerebral hemorrhage. No other members of the family or close relatives had a similar bleeding tendency. Computed tomography and cerebral angiography were carried out but they were negative. Biopsy of the brain around the hematoma was carried out which revealed no brain tumor, arteriovenous malformation and no cerebral amyloid angiopathy. Coagulation tests such as bleeding time and prothrombin time were also negative, but quantitative analysis of coagulation factors revealed incomplete deficiency of factor XI and factor XIII. The value of factor XI and factor XIII were 50.4% and 40-70% respectively.Therefore repeated intracerebral hemorrhage may be caused by these factor deficiencies.
Computed tomography or cerebral angiography in patients with repeated non-traumatic intracerebral hemorrhage may uncover an underlying cause of disorder. But quantitative analysis of coagulation factors is also recommended in all patients with unexplained non-traumatic intracerebral hemorrhage.
