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Abstract Details

Simultaneous Ischemic stroke and Intracerebral Hemorrhage due to Amyloid Angiopathy presenting as a Therapeutic Challenge
Cerebrovascular Disease and Interventional Neurology
P5 - Poster Session 5 (5:30 PM-6:30 PM)
3-037
To report a case of simultaneous intracerebral hemorrhage (ICH) and ischemic stroke.
Both risks of ischemic stroke and ICH increase with age, with the prevalence of risk factors of atrial fibrillation and cerebral amyloid angiopathy that increase with age. Concurrent ischemic stroke and ICH are rare but present management challenges.
Case report and literature review.
65 year old male with history of hypertension, hyperlipidemia, and type 2 diabetes mellitus presented with left sided weakness, facial droop, and dysarthria. Head CT showed a 1.5 cm acute left parietal lobe hemorrhage and arterial imaging demonstrated a sub-occlusive thrombus in the right inferior M2 division of the middle cerebral artery. The presence of ICH precluded the use of thrombolytics. MRI demonstrated acute cerebral ischemia in the right basal ganglia and corona radiate, acute hemorrhage in the left parietal region, and multiple cortical lobar microhemorrhages suggestive of probable cerebral amyloid angiopathy.
Concurrent acute ischemic stroke and contralateral acute intracerebral hemorrhage present management challenges. Compensatory hypertension from ischemic stroke might have contributed to the acute hemorrhage.
Authors/Disclosures
Moein Amin, MD (Cleveland Clinic)
PRESENTER 		Dr. Amin has nothing to disclose.
Dinesh V. Jillella, MD (Emory University School of Medicine / Grady Memorial Hospital) Dr. Jillella has nothing to disclose.
Ken Uchino, MD (Cleveland Clinic Foundation) Dr. Uchino has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Aboott Laboratories, Inc.. Dr. Uchino has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for ACP JOURNAL CLUB. The institution of Dr. Uchino has received research support from NIH.