RT Journal Article
SR Electronic
T1 Early spontaneous hematoma in cerebral infarct
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP 837
OP 837
DO 10.1212/WNL.41.6.837
VO 41
IS 6
A1 Julien Bogousslavsky
A1 Franco Regli
A1 Antoine Uské
A1 Philippe Maeder
YR 1991
UL http://n.neurology.org/content/41/6/837.abstract
AB We identified 15 patients (63 ± 8 years) in whom CT showed no bleeding within 6 hours of stroke onset but showed ganglionic or lobar hemorrhage less than 18 hours later, without visible underlying infarct (early spontaneous intra-infarct hematoma [ESIH]). No patient had antithrombotic therapy or a coagulation disorder, but eight had hypertension. The second CT was prompted by rapid worsening (in 10) or because the first CT was not available (in five). Prior transient ischemic attacks, silent infarcts on CT, and a potential cardiac source of embolism were more common in patients with ESIH than in 200 patients with primary cerebral hemorrhage (PCH) admitted during the same period. Distal occlusions were present in four of five patients who underwent intracranial studies within the first 2 days. Most of these patients probably had embolism with early and extensive bleeding in the ischemic area. Our findings suggest that ESIH may be under-recognized, while PCH may be overdiagnosed.