title: [Multiple intracerebral microhemorrhages associated with primary aldosteronism: a case report].
abstract: We have observed dot-like low intensity spots (a dot-like hemosiderin spot: dotHS) on T2*-weighted (T2*-w) MRI, subsequently diagnosed histologically as previous microbleeds associated with lipohyalinosis, amyloid angiopathy and cerebral small vessel disease (SVD) including an intracerebral hematoma (ICH) and a lacunar infarction. According to the literature, primary aldosteronism (PA), characterized by hypertension, is related to SVD. A 49-year-old female with a long history of untreated hypertension secondary to PA was admitted to our hospital for medical examinations on July 18th, 2000. She had the stepwise development of dementia, dysarthria and gait disturbance (right hemiparesis). CT and MRI demonstrated multiple lacunar infarctions. She was readmitted to our hospital on Jan 23rd, 2002. A neurological examination revealed right hemiparesis, dysarthria and consciousness disturbance. CT on admission demonstrated ICH in the left midbrain. Six days after the hemorrhage, T2*-w MRI showed thirty-two dotHSs in the basal ganglias and the cortical-subcortical regions. The incidence of ICH in patients with hypertension secondary to PA is reported to be higher than in patients with essential hypertension. Multiple dotHS may be associated with ICH, lacunar infarction, and severe microangiopathy related to hypertension secondary to PA.
authors.affiliation: Emergency Care Unit, Hakodate Municipal Hospital, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Miyata
authors.forename: Toshio
authors.initials: T
authors.lastname: Imaizumi
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Horita
authors.forename: Yuji
authors.initials: Y
authors.lastname: Hashimoto
authors.forename: Katsutoshi
authors.initials: K
authors.lastname: Tanno
authors.forename: Akitomo
authors.initials: A
authors.lastname: Koide
authors.forename: Jun
authors.initials: J
authors.lastname: Niwa
mesh_terms: D020520:Brain Infarction / Q000150:complications / Q000473:pathology; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000150:complications* / Q000473:pathology; D020299:Intracranial Hemorrhage, Hypertensive / Q000209:etiology* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008875:Middle Aged