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Small Capsular Hemorrhages: Clinical-Computed Tomographic Correlations

Small Capsular Hemorrhages: Clinical-Computed Tomographic Correlations Abstract • Ten patients' hemorrhagic capsular lesions were detected by computed tomography (CT). Nine of these ten patients had systemic arterial hypertension. Two patients had prior transient ischemic episodes that were of the same nature and suggested the same vascular territory as the subsequent capsular hemorrhage. All of the patients had the sudden onset of maximal neurologic deficit and none showed progressive worsening. Seven patients had pure motor hemiparesis and three had motor weakness with mild sensory impairment. The CT showed capsular hemorrhage in all cases without extension into the thalamus or basal ganglia. None of the hemorrhages caused mass effect or showed surrounding hypodense rim. In nine cases there was a rapid and complete neurologic improvement and in only one case did the patient show mild residual neurologic deficit. These ten cases emphasize the potential dangers of anticoagulation in patients who have not had a prior CT scan. References 1. Fisher CM: Lacunar strokes and infarcts: A review . Neurology 1982;32:871-876.Crossref 2. Fisher CM: The arterial lesions underlying lacunes . Acta Neuropathol 1969;12:1-15.Crossref 3. Fisher CM: Capsular infarcts: The underlying vascular lesions . Arch Neurol 1979;36:65-73.Crossref 4. Donnan GA, Tress BM, Bladin PF: A prospective study of lacunar infarction using computerized tomography . Neurology 1982;32:49-56.Crossref 5. Mohr JP: Lacunes . Neurol Clin North Am 1983;1:201-221. 6. Mohr JP: Lacunes . Stroke 1982;13:3-11.Crossref 7. Mohr JP, Caplan LR, Melski JW, et al: The Harvard Cooperative Stroke Registry: A prospective registry . Neurology 1978;28:754-762.Crossref 8. Fisher CM, Curry HB: Pure motor hemiplegia of vascular origin . Arch Neurol 1965;13:30-44.Crossref 9. Dobkin BH: Lacunar stroke in progression . Stroke 1983;14:421-423.Crossref 10. Rascol A, Clanet M, Manelfe C, et al: Pure motor hemiplegia: CT study of 30 cases . Stroke 1982;13:11-17.Crossref 11. Weisberg LA: Computed tomography and pure motor hemiparesis . Neurology 1979;29:490-495.Crossref 12. Grootheus DR, Duncan GW, Fisher CM: The human thalamocortical sensory path in the internal capsule: Evidence from a small capsular hemorrhage causing a pure sensory stroke . Ann Neurol 1977;2:328-331.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Small Capsular Hemorrhages: Clinical-Computed Tomographic Correlations

Weisberg, Leon A.; Wall, Michael
Archives of Neurology , Volume 41 (12) – Dec 1, 1984
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Publisher
American Medical Association
Copyright
Copyright © 1984 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1984.04050230037014
Publisher site
See Article on Publisher Site

Abstract

Abstract • Ten patients' hemorrhagic capsular lesions were detected by computed tomography (CT). Nine of these ten patients had systemic arterial hypertension. Two patients had prior transient ischemic episodes that were of the same nature and suggested the same vascular territory as the subsequent capsular hemorrhage. All of the patients had the sudden onset of maximal neurologic deficit and none showed progressive worsening. Seven patients had pure motor hemiparesis and three had motor weakness with mild sensory impairment. The CT showed capsular hemorrhage in all cases without extension into the thalamus or basal ganglia. None of the hemorrhages caused mass effect or showed surrounding hypodense rim. In nine cases there was a rapid and complete neurologic improvement and in only one case did the patient show mild residual neurologic deficit. These ten cases emphasize the potential dangers of anticoagulation in patients who have not had a prior CT scan. References 1. Fisher CM: Lacunar strokes and infarcts: A review . Neurology 1982;32:871-876.Crossref 2. Fisher CM: The arterial lesions underlying lacunes . Acta Neuropathol 1969;12:1-15.Crossref 3. Fisher CM: Capsular infarcts: The underlying vascular lesions . Arch Neurol 1979;36:65-73.Crossref 4. Donnan GA, Tress BM, Bladin PF: A prospective study of lacunar infarction using computerized tomography . Neurology 1982;32:49-56.Crossref 5. Mohr JP: Lacunes . Neurol Clin North Am 1983;1:201-221. 6. Mohr JP: Lacunes . Stroke 1982;13:3-11.Crossref 7. Mohr JP, Caplan LR, Melski JW, et al: The Harvard Cooperative Stroke Registry: A prospective registry . Neurology 1978;28:754-762.Crossref 8. Fisher CM, Curry HB: Pure motor hemiplegia of vascular origin . Arch Neurol 1965;13:30-44.Crossref 9. Dobkin BH: Lacunar stroke in progression . Stroke 1983;14:421-423.Crossref 10. Rascol A, Clanet M, Manelfe C, et al: Pure motor hemiplegia: CT study of 30 cases . Stroke 1982;13:11-17.Crossref 11. Weisberg LA: Computed tomography and pure motor hemiparesis . Neurology 1979;29:490-495.Crossref 12. Grootheus DR, Duncan GW, Fisher CM: The human thalamocortical sensory path in the internal capsule: Evidence from a small capsular hemorrhage causing a pure sensory stroke . Ann Neurol 1977;2:328-331.Crossref

Journal

Archives of Neurology – American Medical Association

Published: Dec 1, 1984

References

  • Lacunar strokes and infarcts: A review
    Fisher CM
  • The arterial lesions underlying lacunes
    Fisher CM
  • Capsular infarcts: The underlying vascular lesions
    Fisher CM
  • A prospective study of lacunar infarction using computerized tomography
    Donnan GA, Tress BM, Bladin PF
  • Lacunes
    Mohr JP
  • Lacunes
    Mohr JP
  • The Harvard Cooperative Stroke Registry: A prospective registry
    Mohr JP, Caplan LR, Melski JW, et al
  • Pure motor hemiplegia of vascular origin
    Fisher CM, Curry HB
  • Lacunar stroke in progression
    Dobkin BH
  • Pure motor hemiplegia: CT study of 30 cases
    Rascol A, Clanet M, Manelfe C, et al
  • Computed tomography and pure motor hemiparesis
    Weisberg LA
  • The human thalamocortical sensory path in the internal capsule: Evidence from a small capsular hemorrhage causing a pure sensory stroke
    Grootheus DR, Duncan GW, Fisher CM