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Rapid resolution of symptoms and signs of intracerebral haemorrhage: case reports

BMJ 1998; 316 doi: https://doi.org/10.1136/bmj.316.7143.1495 (Published 16 May 1998) Cite this as: BMJ 1998;316:1495

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Transient neurological deficits and haemorrhages in the elderly

Gunatilake [1] illustrates the importance of obtaining imaging studies in cases of transient neurological events prior to starting anti-platelet agents, by reporting 2 cases of putaminal haemorrhage, which were associated with rapidly resolving neurological deficits. Presentation of intracerebral haemorrhage with transient neurological deficits is uncommon in younger age groups [2,3], but can occur in the setting of cerebral amyloid angiopathy (CAA) in the elderly [4,5]. CAA is a major cause of spontaneous lobar haemorrhages in the elderly. Greenberg and colleagues [4] reported 7 cases of CAA, which were not associated with hypertension, trauma or other antecedent causes. 5 of these cases were associated with transient neurological events. The transient neurological events in such cases may be due to either focal seizures relating to petechial haemorrhages or true short-lived neurological deficits.

References

1. Gunatilake SB. Rapid resolution of symptoms and signs of intracerebral haemorrhage: case reports. BMJ 1998; 316: 1495-1496.

2. Sohn YH, Kim SM, Kim JS, Kim DI. Benign brainstem hemorrhage simulating transient ischemic attack. Yonsei Med J 1991 Mar;32(1):91-93

3. Chen WH, Liu JS, Wu SC, Chang YY. Transient global amnesia and thalamic hemorrhage. Clin Neurol Neurosurg 1996 Nov;98(4):309-311

4. Greenberg SM, Vonsattel JPG, Stakes JW et al. The clinical spectrum of cerebral amyloid angiopathy: Presentations without lobar hemorrhage. Neurology 43: 2073 -

5. Smith DB, Hitchcock M, Philpott PJ. Cerebral amyloid angiopathy presenting as transient ischemic attacks. J Neurosurg 1985; 63: 963-964

Competing interests: No competing interests

20 May 1998
Joe Verghese
(1) Chief resident , (2) Reseach Assistant
Anne Felicia Ambrose
Department of Neurology, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, New Yo