Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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September 7, 2009
Bilateral Symmetric Caudate Head Hemorrhage
- Cerebral hemorrhage limited to the head of the caudate nucleus is very rare (0.1-7%). Bilateral simultaneously caudate hemorrhages are extremely rare.
- Caudate hemorrhages occur mostly in the elderly, often those with long-standing arterial hypertension that causes lesions in the lenticulo-striate arteries.
- Severe stenosis/occlusion of a middle cerebral artery with a fragile anastomotic vessels or angiopathies in younger individuals (moyamoya-like disease) are less frequent but should be considered and excluded by angiography. Differential diagnosis: hypertension, lightning strike, amyloid, methanol, diabetic ketoacidosis, venous thrombosis and fungus (mucor, aspergillus).
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