Small capsular hemorrhages. Clinical-computed tomographic correlations.

Ten patients' hemorrhagic capsular lesions were detected by computed tomography (CT). Nine of these ten patients had systemic arterial hypertension. Two patients had prior transient ischemic episodes that were of the same nature and suggested the same vascular territory as the subsequent capsular hemorrhage. All of the patients had the sudden onset of maximal neurologic deficit and none showed progressive worsening. Seven patients had pure motor hemiparesis and three had motor weakness with mild sensory impairment. The CT showed capsular hemorrhage in all cases without extension into the thalamus or basal ganglia. None of the hemorrhages caused mass effect or showed surrounding hypodense rim. In nine cases there was a rapid and complete neurologic improvement and in only one case did the patient show mild residual neurologic deficit. These ten cases emphasize the potential dangers of anticoagulation in patients who have not had a prior CT scan.