# A Case of Scurvy Associated With Intracerebral Hemorrhage in a Patient With Alcohol Use Disorder

## TL;DR

A 39-year-old man with alcohol use disorder developed a rare brain hemorrhage due to scurvy, highlighting the need to consider vitamin C deficiency in bleeding cases.

## Contribution

This case report presents a rare instance of scurvy causing intracerebral hemorrhage and emphasizes its diagnostic importance.

## Key findings

- Scurvy was diagnosed in a patient with putaminal hemorrhage and bleeding tendencies.
- The patient's symptoms improved after vitamin C supplementation.
- The case underscores the importance of considering scurvy in patients with unexplained bleeding.

## Abstract

Vitamin C deficiency, also known as scurvy, causes abnormalities in connective tissues and varied symptoms. We describe a patient with putaminal hemorrhage, a very rare presentation of scurvy. A 39-year-old man presented with weakness in the left arm and left leg. Right putaminal hemorrhage was initially diagnosed, and he underwent evacuation of the intracerebral hemorrhage. Scurvy was suspected when repeated physical examinations revealed a bleeding tendency and multiple untreated dental caries, missing teeth, and gingivitis. A diagnosis of scurvy was further supported by the patient’s history of smoking, alcohol use disorder, poor diet, and low plasma vitamin C concentration. After receiving oral nutritional supplementation including vitamin C, the bleeding tendency quickly improved. This case highlights the importance of including scurvy in a differential diagnosis for patients with bleeding tendencies, especially those with a poor diet or unknown dietary history. Empirical administration of vitamin C is a reasonable treatment.