Nontraumatic intracerebral hemorrhage in young adults.

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.

[1]  W. Smoker,et al.  The predicted value of arteriography in nontraumatic intracerebral hemorrhage. , 1986, Stroke.

[2]  D. Reed,et al.  Alcohol and hemorrhagic stroke. The Honolulu Heart Program. , 1986, JAMA.

[3]  R. Fallis,et al.  Cerebral vasculitis and hemorrhage associated with phenylpropanolamine , 1985, Neurology.

[4]  J. Chiras,et al.  Cerebral venous thrombosis--a review of 38 cases. , 1985, Stroke.

[5]  C. Filley,et al.  Brain infarction and hemorrhage in young and middle-aged adults. , 1984, The Western journal of medicine.

[6]  H. Hasegawa,et al.  Cerebral neoplasms initially presenting with massive intracerebral hemorrhage. , 1984, Surgical neurology.

[7]  K. Srinivasan.  Ischemic cerebrovascular disease in the young. Two common causes in India. , 1984, Stroke.

[8]  V. Salanova,et al.  Intracerebral haemorrhage and vasculitis secondary to amphetamine use. , 1984, Postgraduate medical journal.

[9]  J. Cutler,et al.  The 1984 Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. , 1984, Archives of internal medicine.

[10]  L. Caplan,et al.  Intracerebral hemorrhage and oral amphetamine. , 1983, Archives of neurology.

[11]  M. Kaste,et al.  Can ethanol intoxication affect hernocoagulation to increase the risk of brain infarction in young adults? , 1983, Neurology.

[12]  D. R. Cooper,et al.  Cerebral angiitis and intracerebral hemorrhage associated with methamphetamine abuse. Case report. , 1983, Journal of neurosurgery.

[13]  Daniel B Hier,et al.  Current concepts of cerebrovascular disease--stroke: stroke and drug abuse. , 1982, Stroke.

[14]  M. Beal,et al.  Cerebral vein thrombosis and multiple intracranial hemorrhages by computed tomography. , 1982, Archives of neurology.

[15]  H. Hasegawa,et al.  Angiographically occult vascular malformations causing intracranial hemorrhage. , 1982, Surgical neurology.

[16]  D. W. Beck,et al.  Intracerebral Hemorrhage in a Patient With Eclampsia , 1981 .

[17]  J. Nelson,et al.  Association of cerebral infarction and chronic alcoholism: an autopsy study. , 1981, Alcoholism, clinical and experimental research.

[18]  M. Kaste,et al.  Ethanol Intoxication: A Risk Factor for Ischemic Brain Infarctionin Adolescents and Young Adults , 1981, Stroke.

[19]  R. Ethier,et al.  THE COMPUTERIZED TOMOGRAPHIC APPEARANCE OF ANGIOGRAPHICALLY OCCULT ARTERIOVENOUS MALFORMATIONS OF THE BRAIN , 1981, Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques.

[20]  K. Davis,et al.  Lobar cerebral hemorrhages: Acute clinical syndromes in 26 cases , 1980, Annals of neurology.

[21]  B. Guidetti,et al.  Intracranial arteriovenous malformations. Conservative and surgical treatment. , 1980, Journal of neurosurgery.

[22]  J. Chopra,et al.  Clinical features and risk factors in stroke in young , 1979, Acta neurologica Scandinavica.

[23]  R. Okeda,et al.  Detection of cryptic vascular malformations by computerized tomography. Report of two cases. , 1979, Journal of neurosurgery.

[24]  A. Nishimoto.  [Moyamoya disease(author's transl)]. , 1979, Neurologia medico-chirurgica.

[25]  R. Zimmerman,et al.  Cranial computed tomography in the diagnosis of systemic lupus erythematosus , 1979, Annals of neurology.

[26]  J. B. Golden,et al.  The angiographically occult cerebrovascular malformation. Report of three cases. , 1978, Journal of neurosurgery.

[27]  P. Averback.  Primary cerebral venous thrombosis in young adults: The diverse manifestations of an underrecognized disease , 1978, Annals of neurology.

[28]  K. Edwards.  Hemorrhagic complications of cerebral arteritis. , 1977, Archives of neurology.

[29]  A. H. Koo,et al.  Metastatic Tumor Presenting as Intracerebral Hemorrhage , 1977 .

[30]  R. Hayward.  Intracranial arteriovenous malformations. Observations after experience with computerised tomography. , 1976, Journal of neurology, neurosurgery, and psychiatry.

[31]  M. Scott,et al.  Spontaneous intracerebral hematoma caused by cerebral neoplasms. Report of eight verified cases. , 1975, Journal of neurosurgery.

[32]  D. Tatter,et al.  Necrotizing angiitis associated with drug abuse. , 1970, The New England journal of medicine.

[33]  R. Siekert,et al.  Central nervous system manifestations of periarteritis nodosa , 1965, Neurology.

[34]  H. Vaughan,et al.  Intracranial hemorrhage due to metastatic chorionepithelioma , 1962, Neurology.