1999 Volume 21 Issue 3 Pages 335-340
Simultaneously multiple intracerebral hemorrhage is very rare. We report an 80-year-old hypertensive man with multiple intracerebral hemorrhage occurring simultaneously in the supra-and infratenorial regions. At admission, he displayed consciousness disturbance and left hemiparesis. His blood pressure was over 300/ 150 mmHg. Laboratory examinations revealed a low cholesterol value (115 mg/ml). Brain CT scans were per-formed within one hour after the onset. They showed right putaminal, thalamic, and night cerebellar hemorrhage. Brain MRI revealed three hematomas that were independently isolated and sxihibited the same aging pattern. It appeared that these hemorrhages had occurred simultaneously on one side of the supra-and infrat-entorial brain. No causative factors such as vascular angitis were identified.
A retrospective analysis was performed on 104 consecutive patients with hypertensive intracerebral hemorrhage at our hospital during a one-year period in 1997.
The hemorrhage sites and frequencies were as follows : putamen (45.2%). thalamus (25.0%), brain stem (10.6%), subcortical region (8.6%) and cerebellar region (7.7%). Hypertensive hemorthage of the subcorti-cal and cerebellar regions occurred most frequently in elderly patients as compared to otherregions. Simultaneously multiple intracerebral hemorrhage was encountered in 3 patients (2.9%). All of them except the present patient showed a combination of the putamen and thalamus. We reviewed 22 patients with simultaneous multiple intracerebral hemorrhage occuring in the supra-and infratentorial regions in the Japanese literature with respect to their clinical characteristics pathogenesis of multiple hematomas and prognosis. Our case is the first reported patient involving three simultaneously hemorrhagic sites.
