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Non-contrast helical acquisition with multiplanar reformats
Contrast studies were not performed because of previous thyroid disorder and planned contrast enhanced MRI and MRA will follow.
There is a hyperdense lesion measuring 15 x 13 x 16 mm (AP x LR x SI) in the right middle cerebellar peduncle with surrounding hypoattenuation extending into the right cerebellar hemisphere and pons. A tubular, serpiginous hyperdense structure coursing through the right cerebellopontine angle cistern and along the inferior margin of the lesion is in keeping with a prominent vessel, probably petrosal vein. A small speck of calcification is situated immediately posteroinferior to the haemorrhage. There is associated mass effect, with expansion of the right middle cerebellar peduncle and partial effacement of the fourth ventricle. No hydrocephalus.
Note hyperdense mass adjacent to right anterior clinoid process.
No further intracranial haemorrhage detected. No evidence of acute ischaemia. No calvarial abnormality. The imaged paranasal sinuses and mastoid air cells are clear.
Right middle cerebellar peduncle haemorrhage is favoured to represent haemorrhage due to an underlying AVM/AVF or cavernous malformation. Less likely differential diagnoses include haemorrhagic metastasis or hypertensive haemorrhage. Suspect Right ICA aneurysm adjacent to anterior clinoid. MRI/MRA is recommended for further evaluation.