Spontaneous Multifocal Intracranial Hemorrhage In A Young Patient

Abstract

Introduction: A stroke is an acute neurologic condition resulting from a disruption in cerebral perfusion, either due to ischemia (ischemic strokes) or hemorrhage (hemorrhagic strokes). Hemorrhagic strokes are further classified as intracerebral or subarachnoid. Clinically, strokes are characterized by the acute onset of focal neurologic deficits, including hemiparesis, paresthesias, and hemianopsia. Systemic hypertension and other cardiovascular diseases are common risk factors for both ischemic and hemorrhagic strokes. For both ischemic and hemorrhagic strokes, age is the most important nonmodifiable risk factor and arterial hypertension is the most important modifiable risk factor. Case: A 25-year-old man presented to our emergency department with a headache, Broca aphasia, and difficulty in vision that started two days ago. The patient stated to have blurry eyes in the morning for a month. However, aphasia had just started before he came to the Emergency room. The patient has had no known past medical history and no medication use. The general situation was bad. Glasgow was 10. He was conscious but was disoriented and non- cooperated, with no verbal response. Blood pressure was 149/82, Pulse was 113, spO2 was 95%, and fever was 36 °C. Ophthalmologic examination showed that visual acuity of the right eye was 2 MPS, 0.1 MPS of the left eye. Intraocular pressures were normal bilaterally. DIIR +/+, no RAPD. Movements of globes were normal and without pain. Bilateral corneas were lucent, and the anterior chambers were quiet. Bilateral hemorrhagic areas were seen in dilated fundus examination.