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February 1984

Cold-Related Intracerebral Hemorrhage

Author Affiliations

From the Department of Neurology, Michael Reese Hospital, Chicago.

Arch Neurol. 1984;41(2):227. doi:10.1001/archneur.1984.04050140129043

A mbient temperature is usually not considered important in the origin of stroke. During a severe winter freeze, we studied three patients with intracerebral hemorrhage (ICH) whose cases stimulated us to examine a possible relationship between cold exposure and ICH.


Case 1.  —A 35-year-old alcoholic man was "shaky" from alcohol withdrawal and so ventured outdoors (temperature, —34 °C) to purchase whiskey. On his way home, a left hemiplegia developed. A computed tomographic (CT) scan demonstrated a moderate-sized right putaminal hemorrhage. His BP was 130/106 mm Hg on admission but fell to 120/70 mm Hg the next day and averaged 120/80 mm Hg during the remainder of his hospitalization without treatment. He had no known prior hypertension.

Case 2.  —A right putaminothalamic hemorrhage developed in a 70-year-old man with slight prior hypertension after he manually wiped snow from his windshield for 15 minutes. His BP, initially 170/110 mm Hg, declined to 130/80 mm Hg after hydrochlorothiazide was prescribed.

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