The existence of traumatic intracerebral hemorrhage is generally conceded, yet the finding of a blood clot in the region of the internal capsule at autopsy is ordinarily accepted as positive evidence that the lesion represents a spontaneous hemorrhage. If signs of trauma are present, the temptation is to consider such trauma as secondary to the unconsciousness and fall resulting from the apoplexy.
Courville and Blomquist,1 in a discussion of traumatic intracranial hemorrhage, presented 38 instances occurring among 439 cases of fatal craniocerebral injuries. Only 7 cases of traumatic hemorrhage into the ganglionic region (external capsule and lenticular nucleus) were included. They stated:
. . . . No example of gross hemorrhage into the posterior limb of the internal capsule, such as appears spontaneously in cases of hypertension or arteriosclerosis, has been observed by us. It may, therefore, be safely assumed that gross hemorrhage in this region is not the result of trauma, for,
ANGRIST A, MITCHELL N. TRAUMATIC HEMORRHAGE OF THE INTERNAL CAPSULE. Arch Surg. 1943;46(2):265-276. doi:10.1001/archsurg.1943.01220080101009