Occipital lobe hemorrhages; clinical-computed tomographic correlations.

Eighteen patients with occipital hematomas are analyzed. Six patients with medial occipital hematomas presented with headache and visual blurring and examination showed homonymous hemianopsia. Three of these six patients were normotensive; three others were hypertensive with chronic vascular changes. Three patients with lateral occipital hematomas presented with headache but had no neurological deficit. All were hypertensive and had evidence of chronic hypertensive vascular changes. Nine patients with larger occipital hematomas which extended into the temporal and parietal region with intraventricular and tentorial extension had an underlying etiology defined by laboratory studies (excessive anticoagulation, coagulation disorder, systemic lupus erythematosus, bacterial endocarditis). None of these patients were hypertensive. The clinical outcome was good in patients with medial and occipital hematomas; however with the larger and more extensive occipital hematomas, clinical outcome was dependent upon the underlying etiology. None of these 18 patients had recurrent stroke.