Hyperacute intracerebral hemorrhage on MRI and CT

Case contributed by Yves Leonard Voss
Diagnosis certain

Presentation

Presentation with initial left sided hemiplegia for 2 hours and quickly developing coma.

Patient Data

Age: 60 years
Gender: Male
This study is a stack
Axial
non-contrast
This study is a stack
Axial bone
window
Download
Info

Hyperacute intracranial hemorrhage affecting the right thalamus with extension into the ventricle, hyperdense on CT.

This study is a stack
Axial
FLAIR
This study is a stack
Axial
T1
This study is a stack
Axial
DWI B0
This study is a stack
Axial DWI
B1000
This study is a stack
Axial
ADC
This study is a stack
Axial
SWI
Download
Info

Hyperacute intracranial hemorrhage affecting the right thalamus with extension into the ventricle. Imaging at 3T MRI.

T1 isointense signal.

T2 FLAIR partially isointense (representing the clot), partially slightly hyperintense (representing a halo of serum outside of the clot).

DWI/ADC demonstrating restricted diffusion of the clot, facilitated diffusion of the halo (serum adjacent to the clot).

SWI demonstrating signal loss.

Case Discussion

Hyperacute intracranial hemorrhage affecting the right thalamus with extension into the ventricle. In the elderly, the most common cause of this type of hemorrhage is poorly controlled hypertension. In younger patients, or those without hypertension, an underlying vascular or potentially neoplastic lesion should be sought. 

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

:

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.