Massive cerebral infarction following evacuation of intracerebral hematoma

Abstract

Rarely primary ICH and infarction can occur simultaneously and development of cerebral infarction soon after intracerebral hemorrhage is still rarer. Uncontrolled atherosclerotic risk factors including hypertension and hyperlipidemia together with antithrombotic therapy are the major reasons for the simultaneous ischemic and hemorrhagic lesions. We report a 67 year male presented with history of sudden onset of left hemiplegia. An urgent CT scan brain showed a large right basal ganglionic hematoma with mass effect and midline shift. The patient underwent evacuation of hematoma. After initial improvement the patient again deteriorated on day 3. A follow up CT scan showed hemorrhagic infarct at the site of surgery with mass effect and midline shift.

Keywords

• intracranial hematoma
• cerebral infarction
• hypertension