title: Multiple Simultaneous Spontaneous Intracerebral Hemorrhages: A Rare Entity.
abstract: BACKGROUND
  In hospital databases, multiple simultaneous spontaneous intracerebral hemorrhages (ICH-m) account for 0.7-5.6% of all ICHs. Their long-term outcome has never been systematically and prospectively investigated. We aimed at identifying the long-term outcome of patients with ICH-m.
  
  
  METHODS
  We prospectively recruited consecutive adults with ICH-m and followed them up for at least 4.5 years. We classified patients into the following 3 groups: (i) definite or probable cerebral amyloid angiopathy (CAA), (ii) deep perforating vasculopathy (DPV) and (iii) unknown causes.
  
  
  RESULTS
  Of 562 consecutive patients with ICH, 32 had ICH-m (5.7%): 8 (25%) with probable CAA, 5 (16%) with DPV and 19 (59%) with ICH-m of undetermined cause. At the last visit (cumulative follow-up of 39.5 person-year), 27 patients (84%) had died, and 3 of the 5 survivors were independent. Late-onset seizures, recurrent ICH-m (symptomatic or not) and new brain microbleeds were mainly found in patients with probable CAA.
  
  
  CONCLUSIONS
  ICH-m is a rare but extremely severe expression of ICH. Survivors with CAA are more likely to develop late seizures and new hemorrhagic lesions. Because of low survival rates, large multicenter cohort studies are needed for a better understanding of this rare condition.
authors.affiliation: Department of Neurology, University of Lille, UDSL, CHU Lille, INSERM U 1171, Lille, France.
authors.forename: Yaohua
authors.initials: Y
authors.lastname: Chen
authors.forename: Hilde
authors.initials: H
authors.lastname: Hénon
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Bombois
authors.forename: Florence
authors.initials: F
authors.lastname: Pasquier
authors.forename: Charlotte
authors.initials: C
authors.lastname: Cordonnier
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020144:Basal Ganglia Cerebrovascular Disease / Q000150:complications / Q000473:pathology*; D001921:Brain / Q000473:pathology*; D016657:Cerebral Amyloid Angiopathy / Q000150:complications / Q000473:pathology*; D002543:Cerebral Hemorrhage / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D035583:Rare Diseases / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D012640:Seizures / Q000453:epidemiology*