TITLE:
Intracerebral Hemorrhage Secondary to Chronic Left Middle Cerebral Artery Occlusion: Diagnostic Challenges and Clinical Implications
AUTHORS:
Tarsila Stockler Ravaschieri Martinolli, Daniel Gurgel Fernandes Távora, Francisco Barbosa de Araújo Neto, Dárvylla de Sousa Lima, Matheus Cardoso Aragão, Antonio Victor Gouveia Azevedo dos Santos, Rafael de Oliveira Sousa, João Vitor Lopes Montes, Rodolfo Ebert de Oliveira Garcia
KEYWORDS:
Intracerebral Hemorrhage, Middle Cerebral Artery Occlusion, Collateral Circulation, Cocaine, Neuroimaging
JOURNAL NAME:
Open Journal of Medical Imaging,
Vol.15 No.4,
October
31,
2025
ABSTRACT: Intracerebral Hemorrhage (ICH) is a severe form of stroke with high morbidity and mortality. While Middle Cerebral Artery (MCA) occlusion typically results in ischemic infarction, ICH secondary to chronic MCA occlusion without concomitant ischemia is an exceedingly rare phenomenon that challenges both diagnosis and management. We report a 45-year-old male with multiple cardiovascular risk factors presenting with acute focal neurological deficit, which emphasizes the importance of considering chronic MCA occlusion as a potential etiology of ICH, even in the absence of infarction. Radiological evaluation, especially with magnetic resonance imaging, is essential to guide prevention and management strategies.