We read with interest the article by Mauriño et al1 describing multiple simultaneous intracerebral hemorrhage (ICH). Using similar methods, we observed 7 cases (1.7%) of multiple simultaneous ICH in a cohort of 423 patients from Toronto, Ontario, with primary ICH.2 In contrast to the current series from Buenos Aires, Argentina, in which multiple subcortical hemorrhages associated with hypertension were the sole hemorrhage type, we noted that all 7 patients from Toronto had lobar-type hemorrhages and that none had a history of hypertension. For 2 of them, pathological findings were available, and both patients were shown to have amyloid angiopathy. The mean ± SD age was 63 ± 15 years, and 6 of the 7 patients survived to 1 year.
Hill MD, Silver FL. Association Between Lobar-Type Hemorrhage and Amyloid Angiopathy. Arch Neurol. 2001;58(10):1705. doi: