Small capsular hemorrhages. Clinical-computed tomographic correlations
L. A. Weisberg and M. Wall
Ten patients' hemorrhagic capsular lesions were detected by computed
tomography (CT). Nine of these ten patients had systemic arterial
hypertension. Two patients had prior transient ischemic episodes that were
of the same nature and suggested the same vascular territory as the
subsequent capsular hemorrhage. All of the patients had the sudden onset of
maximal neurologic deficit and none showed progressive worsening. Seven
patients had pure motor hemiparesis and three had motor weakness with mild
sensory impairment. The CT showed capsular hemorrhage in all cases without
extension into the thalamus or basal ganglia. None of the hemorrhages
caused mass effect or showed surrounding hypodense rim. In nine cases there
was a rapid and complete neurologic improvement and in only one case did
the patient show mild residual neurologic deficit. These ten cases
emphasize the potential dangers of anticoagulation in patients who have not
had a prior CT scan.
