Cerebral subacute hemorrhagic infarction

Case contributed by Dr Mohammad A. ElBeialy


Adult diabetic and hypertensive male with right sided hemiplegia for a week.

Patient Data

Age: 55
Gender: Female
  •  A large left temporo-occipital, left insular and basal ganglia as well as fronto-parietal cortical and subcortical patchy areas of restricted diffusion are seen demonstrating high DWI and low ADC signal. They demonstrate high T2 / FLAIR signal, as well as subtle hypointense T1 with patchy T1 hyperintensities and GRE blooming in the left basal ganglia and temporo-occipital region; denoting met Hb signal of hemorrhagic transformation. Mild mass effect is seen on the left lateral ventricle by the cytotoxic edema.
  • Mild dilatation of the ventricular system.
  • Bilateral cerebral deep white matter as well as bilateral basal ganglia and pontine demyelinating foci with high T2 / FLAIR signal are seen; likely ischemic.
  • Widened extra-axial CSF spaces.


Case Discussion

  • Large left temporo-occipital and fronto-parietal subacute hemorrhagic infarction.
  • Mild atrophic brain changes with peri-ventricular arterio-sclerotic leucoencephalopathy, as well as small deep white matter, basal ganglia and pontine chronic small vessel disease.
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Case information

rID: 23780
Published: 7th Jul 2013
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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