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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Bibliographic Details
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
Online Access:Get more information
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Summary: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.
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ISSN:1526-632X
1526-632X
DOI:10.1212/WNL.0000000000209796