Simultaneous occurrence of internal capsule infarct and cerebellar haemorrhage in a patient with hemiplegia

Abstract

SUMMARYA 68-year-old woman with hypertension with no history of cerebrovascular events presented with a left-sided hemiplegia which had developed acutely 2 days ago. She was not on maintenance therapy with antiplatelets or anticoagulants. A CT scan showed acute ischaemic infarction of the right internal capsule and cerebellar haemorrhage. Cardiac evaluation was normal. Doppler ultrasonography of the extracranial carotid and vertebral arteries showed diffuse arteriosclerotic changes, but did not reveal any haemodynamic occlusion. The simultaneous development of dual strokes was considered to be an extension of the same arteriosclerotic process to the intracranial carotid and basilar arteries. BACKGROUND

Simultaneous presentation of subcortical hemorrhage, subdural hemorrhage, and cerebral infarct in a hemiplegic patient

“…Dissections in the cerebral arteries and reversible cerebral vasoconstriction syndrome are frequent causes of such subarachnoid hemorrhage [1 , [5] , [6] , [7] , [8] , 10 , 12] . Also, intracerebral hemorrhage found simultaneously with an ischemic stroke has been documented in the thalamus, cerebellar vermis, and brainstem [2 , 4 , 9 , 13] .…”

“…Usually, it develops as either type, whereas simultaneous diagnosis of ischemic and hemorrhagic strokes is rare occurrence. In such cases, subarachnoid hemorrhages have been frequently documented as hemorrhagic type, while intracerebral hemorrhages have been rare [1] , [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] . Dissections in the cerebral arteries and reversible cerebral vasoconstriction syndrome are frequent causes of such subarachnoid hemorrhage [1 , [5] , [6] , [7] , [8] , 10 , 12] .…”