Transient Neurological Symptoms in Patients With Intracerebral Hemorrhage

IMPORTANCE: Transient symptoms from an intracerebral hemorrhage (ICH) are not well recognized and have previously not been reported. OBJECTIVE: To describe the clinical presentations and neuroimaging findings in a subset of patients with ICH presenting with transient neurological signs and symptoms. DESIGN, SETTING, AND PARTICIPANTS: Clinical case series in which the hospital database of a large academic center in Boston, Massachusetts, was searched using International Classification of Diseases, Ninth Revision code 431 from June 1, 2000, to August 31, 2014, to identify patients with ICH who had transient deficits that resolved completely within 24 hours of symptom onset. MAIN OUTCOMES AND MEASURES: Clinical presentation, neuroimaging findings, and prognosis. RESULTS: Among 3207 consecutive patients with ICH initially screened, 17 fulfilled study criteria (median age, 65 years [interquartile range, 56-73 years]; 11 male). In most patients, recovery from neurological symptoms started within a few hours after onset. Most hemorrhages in this cohort were small, with a mean (SD) hematoma volume of 17 (9.9) mL, and were subcortical in location. One patient died of hemorrhage recurrence. CONCLUSIONS AND RELEVANCE: Patients with ICH can present with rapidly resolving deficits resembling transient ischemic attacks. Recognition of these instances is important to avoid delays in investigations and to manage these cases appropriately.