Massive Brain Hemorrhage: A Review of 144 Cases and an Examination of Their Causes

Author:

McCORMICK WILLIAMS F.1,ROSENFIELD DAVID B.2

Affiliation:

1. Division of Neuropathology, University of Texas Medical Branch, Galveston, Texas 77550. Formerly, Chief, Division of Neuropathology, University of Iowa, Iowa City, Iowa

2. Duke University, Durham, North Carolina. Formerly, Junior Resident in Neurology, University of Iowa, Iowa City, Iowa

Abstract

A detailed clinicopathological study of the causes and locations of massive nontraumatic brain hemorrhage in 144 patients is reported. A cause of the hemorrhage, such as an aneurysm, angioma, arteritis, neoplasm or a blood dyscrasia (leukemia, hemophilia), was proved in two-thirds (95) of these patients. Twelve normotensive patients had no cause found to explain their hemorrhage. Systemic hypertension, generally mild, defined as a pre-ictal pressure of > 140/90 or by excessive heart weight, was present in 58 of the 144 patients. Twenty-one of these 58 hypertensive patients had a clear discernible cause for their brain hemorrhage (i.e., leukemia, metastatic carcinoma, angioma, aneurysm), whereas no satisfactory morphological cause could be found in only 37. Thus, in only about one-fourth of our patients could any serious claim be made that hypertension was the cause of the hemorrhage. Our data would indicate the need for a critical study of the causes of intracranial hemorrhages, and re-evaluation of the true relationship of systemic hypertension to such strokes. The widespread dogma that hypertension is the outstanding cause of nontraumatic brain hemorrhage no longer seems warranted.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Advanced and Specialized Nursing,Cardiology and Cardiovascular Medicine,Neurology (clinical)

Reference10 articles.

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2. Spontaneous Intracerebral Hemorrhage

3. Hypertension: Deficient Care of the Medically Served

4. Kurtzke JF: Epidemiology of Cerebrovascular Disease. New York Springer-Verlag p 81-89 1969

5. McCormick WF: Problems and pathogenesis of intracranial arterial aneurysms. In Toole JF Moossy J Janeway R (eds) : Cerebral Vascular Diseases. New York Grune and Stratton p 219-231 1971

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