Concomitant cerebral infarction developing soon after a parenchymal intracerebral
hemorrhage is a rare occurrence. Usually, these remote site changes follow tumor decompression
and are associated with hemorrhagic changes rather than infarcts. We report a case
of a fatal malignant internal carotid territory infarct in a hospitalized patient
being conservatively managed for a vermian hematoma and discuss the probable pathophysiology.
Stroke physicians need to be aware that spontaneous intracerebral hematoma patients
have a potential threat of developing large vessel occlusion with malignant cerebral
infarcts, especially after surgical decompression. Although the exact pathogenesis
is unknown, size of the clot, intraventricular hemorrhage, hydrocephalus, and aggressive
reduction of blood pressure appear to be predictive factors.
Key-words:
Hematoma - intracerebral - parenchymal - vermian
