Clinical Reasoning: A 50-Year-Old Man With Intracerebral Hemorrhage and Tortuous Retinal Arterioles

A 50-year-old man presented with headache. Examination showed left sided ataxic hemiparesis and elevated blood pressure. Brain imaging revealed an acute intracerebral hemorrhage in the right lentiform nucleus, deep and periventricular white matter hyperintensities, and predominantly deep cerebral mi...

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Published in:Neurology Vol. 103; no. 6; p. e209796
Main Authors: Bouchart, Jean, Weber, Sacha, Coste, Thibault, Laville, Marie-Alice, Loisel, Margaux, Nehme, Ahmad
Format: Journal Article
Language:English
Published: United States 24.09.2024
Subjects:
Arterioles - diagnostic imaging
Arterioles - pathology
Cerebral Hemorrhage - diagnostic imaging
Cerebral Hemorrhage - etiology
Cerebral Small Vessel Diseases - complications
Cerebral Small Vessel Diseases - diagnostic imaging
Clinical Reasoning
Humans
Male
Middle Aged
Retinal Artery - diagnostic imaging
Retinal Artery - pathology
ISSN:1526-632X, 1526-632X
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Abstract A 50-year-old man presented with headache. Examination showed left sided ataxic hemiparesis and elevated blood pressure. Brain imaging revealed an acute intracerebral hemorrhage in the right lentiform nucleus, deep and periventricular white matter hyperintensities, and predominantly deep cerebral microbleeds. Fundus examination showed important arteriolar tortuosity involving several blood vessels. In this young patient, we explain the diagnostic approach to intracerebral hemorrhage, the causes of cerebral small vessel disease, and the interpretation of biomolecular tests.
AbstractList A 50-year-old man presented with headache. Examination showed left sided ataxic hemiparesis and elevated blood pressure. Brain imaging revealed an acute intracerebral hemorrhage in the right lentiform nucleus, deep and periventricular white matter hyperintensities, and predominantly deep cerebral microbleeds. Fundus examination showed important arteriolar tortuosity involving several blood vessels. In this young patient, we explain the diagnostic approach to intracerebral hemorrhage, the causes of cerebral small vessel disease, and the interpretation of biomolecular tests.
A 50-year-old man presented with headache. Examination showed left sided ataxic hemiparesis and elevated blood pressure. Brain imaging revealed an acute intracerebral hemorrhage in the right lentiform nucleus, deep and periventricular white matter hyperintensities, and predominantly deep cerebral microbleeds. Fundus examination showed important arteriolar tortuosity involving several blood vessels. In this young patient, we explain the diagnostic approach to intracerebral hemorrhage, the causes of cerebral small vessel disease, and the interpretation of biomolecular tests.A 50-year-old man presented with headache. Examination showed left sided ataxic hemiparesis and elevated blood pressure. Brain imaging revealed an acute intracerebral hemorrhage in the right lentiform nucleus, deep and periventricular white matter hyperintensities, and predominantly deep cerebral microbleeds. Fundus examination showed important arteriolar tortuosity involving several blood vessels. In this young patient, we explain the diagnostic approach to intracerebral hemorrhage, the causes of cerebral small vessel disease, and the interpretation of biomolecular tests.
Author Weber, Sacha
Nehme, Ahmad
Coste, Thibault
Bouchart, Jean
Laville, Marie-Alice
Loisel, Margaux
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  givenname: Jean
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  surname: Bouchart
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  organization: From the Departments of Neurology (J.B., S.W., M.L., A.N.), Genetics (S.W.), and Ophthalmology (M-A. L.), Université Caen-Normandie, CHU de Caen-Normandie, Caen; NeuroDiderot (T.C.), Université Paris Cité, Inserm UMR 1141; and Service de Génétique Moléculaire Neurovasculaire (T.C.), AP-HP, Hôpital Saint-Louis, Paris, France
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  givenname: Sacha
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  organization: From the Departments of Neurology (J.B., S.W., M.L., A.N.), Genetics (S.W.), and Ophthalmology (M-A. L.), Université Caen-Normandie, CHU de Caen-Normandie, Caen; NeuroDiderot (T.C.), Université Paris Cité, Inserm UMR 1141; and Service de Génétique Moléculaire Neurovasculaire (T.C.), AP-HP, Hôpital Saint-Louis, Paris, France
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  givenname: Marie-Alice
  surname: Laville
  fullname: Laville, Marie-Alice
  organization: From the Departments of Neurology (J.B., S.W., M.L., A.N.), Genetics (S.W.), and Ophthalmology (M-A. L.), Université Caen-Normandie, CHU de Caen-Normandie, Caen; NeuroDiderot (T.C.), Université Paris Cité, Inserm UMR 1141; and Service de Génétique Moléculaire Neurovasculaire (T.C.), AP-HP, Hôpital Saint-Louis, Paris, France
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  givenname: Margaux
  surname: Loisel
  fullname: Loisel, Margaux
  organization: From the Departments of Neurology (J.B., S.W., M.L., A.N.), Genetics (S.W.), and Ophthalmology (M-A. L.), Université Caen-Normandie, CHU de Caen-Normandie, Caen; NeuroDiderot (T.C.), Université Paris Cité, Inserm UMR 1141; and Service de Génétique Moléculaire Neurovasculaire (T.C.), AP-HP, Hôpital Saint-Louis, Paris, France
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  givenname: Ahmad
  orcidid: 0000-0002-7700-6799
  surname: Nehme
  fullname: Nehme, Ahmad
  organization: From the Departments of Neurology (J.B., S.W., M.L., A.N.), Genetics (S.W.), and Ophthalmology (M-A. L.), Université Caen-Normandie, CHU de Caen-Normandie, Caen; NeuroDiderot (T.C.), Université Paris Cité, Inserm UMR 1141; and Service de Génétique Moléculaire Neurovasculaire (T.C.), AP-HP, Hôpital Saint-Louis, Paris, France
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Snippet A 50-year-old man presented with headache. Examination showed left sided ataxic hemiparesis and elevated blood pressure. Brain imaging revealed an acute...
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SubjectTerms Arterioles - diagnostic imaging
Arterioles - pathology
Cerebral Hemorrhage - diagnostic imaging
Cerebral Hemorrhage - etiology
Cerebral Small Vessel Diseases - complications
Cerebral Small Vessel Diseases - diagnostic imaging
Clinical Reasoning
Humans
Male
Middle Aged
Retinal Artery - diagnostic imaging
Retinal Artery - pathology
Title Clinical Reasoning: A 50-Year-Old Man With Intracerebral Hemorrhage and Tortuous Retinal Arterioles
URI https://www.ncbi.nlm.nih.gov/pubmed/39167747
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