Extra Investigation Might Be Necessary in High-Risk CT-Negative Cerebrovascular Cases
- 1 Kingsbrook Jewish Medical Center, Brooklyn, USA
- 2 Department of Physical Education, Krasnodar State Medical University, Krasnodar, Russia.
Abstract
Cerebrovascular accidents occur in elderly patients in whom neurodegenerative changes increase the risk of vascular permeation and concomitant intracranial bleeding. In rare cases, intracerebral massive hemorrhage happens in hospital ized patients with apparently stable clinical picture. We report two cases illustrating this phenomenon, discuss the pos sible pathomechanism involved in those tragic incidents and suggest possible prevention measures for these patients. A negative CT image in a patient with neurological symptoms, especially who are on warfarin with or without considera bly elongated coagulation time, may be subject to a sudden intracranial hemorrhage. Microvascular abnormalities might be detected on perfusion CT imaging and should therefore be performed in all CT negative patients with close observa tion for 24 hours before contemplating discharge.
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