Concurrent Eloquent Area Bleeds in a Patient with Uncontrolled Hypertension

Bishomber Neupane, Ipsa Shakya, Rajiv Neupane, B. Khanal, P. Kafle, E. Gandham
{"title":"Concurrent Eloquent Area Bleeds in a Patient with Uncontrolled Hypertension","authors":"Bishomber Neupane, Ipsa Shakya, Rajiv Neupane, B. Khanal, P. Kafle, E. Gandham","doi":"10.3126/jonmc.v11i2.50906","DOIUrl":null,"url":null,"abstract":"Uncontrolled hypertension being the most important risk factor for intracerebral hemorrhage (ICH) often leads to solitary hematoma whereas multiple spontaneous simultaneous ICH is not common, and occurrence of bilateral hemorrhage is a rare entity with normal bleeding parameters with very few case reports so far. Here, we report a 67-year-old man with a past medical history of uncontrolled hypertension who was brought to the emergency department due to severe headache, worsening confusion for 1 day. An urgent non-contrast brain Computed Tomography (CT) performed immediately revealed bilateral intracerebral hemorrhage (ICH) of the same age in the right putamen and left thalamus. Our patient had a non-traumatic ICH, with low GCS (5/15) at presentation. He was managed conservatively with antihypertensives and antiedema measures. He was discharged in stable condition GCS 14/15 with left hemiparesis (3/5). At last follow up he was recovering well.Due to the rarity of spontaneous intracranial bleed in patient with normal bleeding parameters, it is particularly interesting to report this rare case presentation.","PeriodicalId":52824,"journal":{"name":"Journal of Nobel Medical College","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2022-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Nobel Medical College","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3126/jonmc.v11i2.50906","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

Uncontrolled hypertension being the most important risk factor for intracerebral hemorrhage (ICH) often leads to solitary hematoma whereas multiple spontaneous simultaneous ICH is not common, and occurrence of bilateral hemorrhage is a rare entity with normal bleeding parameters with very few case reports so far. Here, we report a 67-year-old man with a past medical history of uncontrolled hypertension who was brought to the emergency department due to severe headache, worsening confusion for 1 day. An urgent non-contrast brain Computed Tomography (CT) performed immediately revealed bilateral intracerebral hemorrhage (ICH) of the same age in the right putamen and left thalamus. Our patient had a non-traumatic ICH, with low GCS (5/15) at presentation. He was managed conservatively with antihypertensives and antiedema measures. He was discharged in stable condition GCS 14/15 with left hemiparesis (3/5). At last follow up he was recovering well.Due to the rarity of spontaneous intracranial bleed in patient with normal bleeding parameters, it is particularly interesting to report this rare case presentation.
高血压未控制患者并发雄辩区出血1例
不受控制的高血压是脑出血(ICH)最重要的危险因素,常导致孤立性血肿,而多发性自发性同时脑出血并不常见,双侧出血的发生是罕见的,出血参数正常,目前报道的病例很少。在此,我们报告一位67岁的男性,既往有高血压病史未得到控制,因严重头痛而被送往急诊科,意识混乱加剧1天。立即进行的紧急非对比脑计算机断层扫描(CT)显示右侧壳核和左侧丘脑的双侧脑出血(ICH)相同年龄。本例患者为非外伤性脑出血,就诊时GCS低(5/15)。他被保守地管理与抗高血压和抗水肿措施。出院时病情稳定,GCS 14/15,左侧偏瘫(3/5)。最后,他恢复得很好。由于自发性颅内出血的患者在正常出血参数的罕见,这是特别有趣的报告这一罕见的病例表现。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
0.00%
发文量
19
审稿时长
16 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信