Spontaneous Intracerebral Hemorrhage due to Small Vascular Malformations and Unknown Causes

ABSTRACT

Twenty-two patients who had evidence of spontaneous intracerebral hemorrhage in brain computerized tomographic(CT) scan specially with small vascular malformations who were angiographically verified and unknown causes, were reviewed. The majority of patients were in first and second decades of life. The duration of symptoms from onset to admission showed relatively short in verified cases and even distributed from 1 day to 1 month in unknown cases. The most common presenting symptoms and signs were headache and papilledema in unknown cases. In brain CT scan, variable findings were seen as hematoma with surrounding eidence of vascular anomaly, hematoma only and blood-fluid level in verified cases, and tumor-like findings in unknown cases. The most common site of hematoma were parietal and occipital lobes in verified cases and were parietal and infratentorial area in unknown cases. The results achieved with excision of these cases were good. These small vascular malformations require special attention because of following view-points: 1) their relative frequent cause of intracerebral hematoma; 2) their variable findings in CT scan ; 3) more careful serial angiographical identification of anomalous vessel with subtraction and magnification; 4) their careful histopathological observation of operative specimen.