Basal ganglia and thalamic haemorrhage with intraventricular extension

Case contributed by Abiola Ayodele
Diagnosis certain

Presentation

Headache, left hemiparesis in a known hypertensive.

Patient Data

Age: 70 years
Gender: Female

Axial non-contrast CT demonstrates an acute intracerebral haemorrhage with perilesional oedema centred in the right basal ganglia and thalamus. There is extension into the lateral, third and fourth ventricles (intraventricular haemorrhage) with associated hydrocephalus and transependymal seepage of CSF. The sulci, gyri and ipsilateral lateral ventricle are effaced. Significant midline shift to the left is noted.

Case Discussion

Hypertension is the most common cause of intracerebral haemorrhage. Typical locations include:

  • basal ganglia
  • thalami
  • pons
  • dentate nucleus of the cerebellum

CT findings are consistent with hypertensive basal ganglia and thalamic haemorrhage with intraventricular extension and consequential obstructive hydrocephalus.

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