Nontraumatic intracerebral hemorrhage in young adults
G. J. Toffol, J. Biller and H. P. Adams Jr
We reviewed our experience with 72 patients, aged 15 to 45 years, who were
hospitalized for nontraumatic intracerebral hemorrhages (ICHs) between 1978
and 1985. Evaluation included arteriography in 61 patients. Computed
tomography demonstrated 41 lobar, 11 putaminal, four thalamic, four
pontine, four intraventricular, two caudate, two midbrain, two cerebellar,
one globus pallidum, and one corpus callosum hemorrhage. Forty-three
patients, with either progressive neurologic deterioration, arteriovenous
malformations (AVMs), or saccular aneurysms underwent surgery. The overall
in-hospital survival, including those patients treated medically, was
87.5%. A presumed cause for the ICH was found in 55 (76.4%) patients. The
main causes were ruptured arteriovenous malformations (21), hypertension
(11), ruptured saccular aneurysms (seven), and sympathomimetic drug abuse
(five). Surgical explorations demonstrated a necrotizing angiitis in one
patient and arteriovenous malformations in two patients who had negative
arteriograms. Young patients with nontraumatic ICHs represent a
heterogeneous group. A cause can be established in most patients.
Arteriovenous malformations account for less than one third of the
hemorrhages in young adults, and other causes should be sought.
Is hypertension a more frequent risk factor for deep than for lobar supratentorial intracerebral haemorrhage?
Jackson and Sudlow
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NINDS ICH Workshop Participants
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Bakheit
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Intracerebral Hemorrhage in Young People : Analysis of Risk Factors, Location, Causes, and Prognosis
Ruiz-Sandoval et al.
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Shin et al.
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Churg-Strauss syndrome presented as multiple intracerebral hemorrhage
Liou et al.
Lupus 1997;6:279-282.
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Lobar Intracerebral Hemorrhage Model in Pigs : Rapid Edema Development in Perihematomal White Matter
Wagner et al.
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Stroke in Young Black Patients : Risk Factors, Subtypes, and Prognosis
Qureshi et al.
Stroke 1995;26:1995-1998.
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Case 27-1993- A 32-Year-Old Man with the Sudden Onset of a Right-Sided Headache and Left Hemiplagia and Hemianesthesia
Tapia and Schumacher
NEJM 1993;329:117-124.
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