Presentation
Headache, hypertension, bradycardia, vomiting, new onset confusion. Intracranial bleed?
Patient Data

Area of hypodensity is noted involving the right occiptal lobe grey and white matter representing infarction with superimposed gyriform pattern of hyperdensites representing hemorrhagic transformation.
Rest of the brain shows cerebral atrophy changes with multiple chronic lacunar infarcts of bilateral thalamo-capsulo-ganglionic regions.













MRI study confirms the CT finding of hemorrhage in the infarction in the form of blooming in the right occipital lobe on GRE images.
Case Discussion
Hemorrhagic transformation occurs due to preserved collateral perfusion or from reperfusion of infarcted tissues which have weakened vessels.