• J M Henselmans, K Meijer, R Haaxma, J Hew, and J van der Meer.
• Department of Neurology, University Hospital Groningen, Netherlands.
• Stroke. 1999 Nov 1;30(11):2479-82.

BackgroundCoagulation disorders can cause intracerebral bleeding that may be difficult to detect since subsequent aberrant clot formation may mask early detection. This is an important pitfall because, when diagnosed early, bleeding in these patients is treatable.Case DescriptionA patient with congenital afibrinogenemia presented with recurrent hemiparesis. Spontaneous intracerebral hemorrhage was diagnosed, despite an initial negative CT scan. Diagnosis, therapy, and complications of therapy are discussed.ConclusionsIntracerebral hemorrhage must be strongly suspected in any patient with a coagulation disorder presenting with matching clinical symptoms. Therapy must be installed immediately, before additional investigations, and should be continued even when initial neuroimaging is negative.

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