Basal ganglia haemorrhage
Found on bedroom floor with marked right sided weakness and right facial droop. Past history of dementia, type 2 diabetes and AF (on aspirin).
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Left sided acute intracerebral haematoma, with its epicentre in the basal ganglia/external capsule. The haemorrhage extends into the intraventricular system. There is no subarachnoid haemorrhage.
There is no hydrocephalus or significant mass effect relating to the haematoma.
Mild generalised cerebral volume loss. Mild periventricular low attenuation in keeping with small vessel change. There are a couple of chronic lacunar infarcts in the basal ganglia
The patient died 4 months after the ICH and underwent post mortem. This showed an old left basal ganglia haemorrhage.
There is severe small vessel disease throughout the cerebral hemispheres with lacunar infarcts, enlarged perivascular spaces and white matter rarefaction. Immunohistochemistry shows parenchymal amyloid deposition in keeping with Alzheimer's pathology but no evidence of amyloid angiopathy.
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