Amin et al. Journal of Medical Case Reports 2011, 5:360 http://www.jmedicalcasereports.com/content/5/1/360 two years of the first hemorrhage. They also found that all of these re-bleedings occurred at sites different from the first ones, but the majority were within the basal ganglia and thalami and all were related to poor arterial blood pressure control. The short-term mortality of recurrent hypertensive hemorrhages is considerably higher (32%) [16] than that of the first hemorrhages (20%) [18]. As for the long term functional outcome, Portenoy et al. [19] found that 55% of patients achieve a good functional recovery after sustaining a hypertensive ICH, a figure that falls to 23% if a recurrence develops [16]. Our patient developed a right-sided deep cerebellar hemorrhage; the subsequent eight weeks were marked by a good functional recovery and optimal blood pres- sure control. Another hemorrhage at the left dentate nuclei occurred after 57 days and resolved in a relatively favorable functional independence. Conventional cere- bral angiography was not done because of the lack of expertise in our hospital’s radiology department. Brain MRA after two weeks revealed no vascular anomaly. Although hypertension is the most common etiology behind the development of non-traumatic intra-cerebral hemorrhage in adults [3,20,21], the occurrence of recur- rent hemorrhages should always prompt the physician to search for an underlying cause(s), such as multiple ischemic strokes with secondary hemorrhagic transfor- mation, reperfusion after thrombolytic therapy, exten- sion from a subarachnoid bleed, vascular anomalies, tumors, congophilic angiopathy, blood dyscrasias, vascu- litis, coagulopathy, and illicit drug use [22-27]. Our patient’s clinical features, examination, and work-up have excluded the risk factors listed above. Conclusion The development of recurrent hypertensive hemorrhage is rare and usually occurs within two years of the first bleed. To the best of our knowledge, this is the first reported case of bilateral, sequential, right- and then left-sided, deep cerebellar hemorrhage. The hemorrhages occurred eight weeks apart and she had a relatively good functional recovery. We believe these hemorrhages were hypertensive in etiology. Consent Written informed consent was obtained from the patient for publication of this case report and any accompany- ing images. A copy of the written consent is available for review by the Editor-in-Chief of this journal. Author details 1Department of Neurology, Sulaimaniya General Teaching Hospital, Sulaimaniya City, Iraq. 2Department of Medicine, Sulaimaniya General Teaching Hospital, Sulaimaniya City, Iraq. Page 3 of 4 Authors’ contributions Clinical management and follow-up was made by OSMA. 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