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January 1991

Migraine and Intracerebral Hemorrhage-Reply

Author Affiliations

Department of Neuroscience The Johns Hopkins University School of Medicine 725 N Wolfe St Baltimore, MD 21205
Montreal Neurological Institute 3801 University St Montreal, Quebec, Canada H3A 2B4

Arch Neurol. 1991;48(1):17-18. doi:10.1001/archneur.1991.00530130025006

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In Reply.  —De Smet and Brucher point out that two cases of intracerebral hemorrhage, both diagnosed at postmortem examination, appear to have been the result of arterial rupture following embolic occlusion. They propose that such rupture may be the consequence of local violent vasospasm following embolic occlusion. While our list of potential causes of cerebral vasospasm was not meant to be exhaustive, we would emphasize that none of our patients had evidence of embolic arterial occlusion demonstrated by acute angiographic studies.Vazquez-Cruz has called our attention to his report of 11 patients with migraine who suffered intracerebral hemorrhage. Nine of those patients had hypertension or identified vascular malformations, one was an alcoholic, and one had no predisposing cause. We are unaware of an association between alcoholism and intracerebral hemorrhage except in the setting of coagulopathy or direct trauma. None the less, none of our patients were alcoholics. Migraine is a

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