Bilateral Putaminal Hemorrahge in a Young Female: A Case Report

Background: The etiology of spontaneous intracerebral hemorrhage (ICH) in young adults may include causative factors such as vascular abnormality, hypertension, anticoagulant therapy, brain tumor, and others. Hypertension is the most common cause of ICH in young adults in Taiwan. Simultaneous or multiple intracerebral hemorrhages are uncommon, and symmetrical distribution is even rarer. Most cases reported in the literature are in the elderly. Case: We report the case of a 29 years old female with a history of hypertension and elevated blood pressure, who presented with an acute onset of right side limb weakness. Results: Brain computed tomography (CT) showed hemorrhage in the left basal ganglia. Another small hematoma was detected in the right basal ganglia with brain magnetic resonance imaging ( MRI) performed within 24 hours. The laboratory examination, including thyroid function, adrenal function, coagulation profile and immunological factors, did not reveal other possible causes of spontaneous ICH. Conclusions: Hypertensive ICH was diagnosed because brain images and laboratory examination did not reveal other possible causes of spontaneous ICH. The clinical characteristics of the care are presented, and the epidemiology and etiology of ICH in young adults are discussed.