Presentation
Vertigo, right sided cerebellar signs ?intracranial hemorrhage.
Patient Data
Parenchymal hemorrhage centered in the posterior limb of the left internal capsule / lateral margin of the thalamus.
Heterogeneous T1 and T2 signal in the left internal capsule is in keeping with the previously demonstrated hematoma, which is resolving. Confluent periventricular and deep white matter high T2/FLAIR signal. Generalized cerebral atrophy with mild ventriculomegaly. Foci of susceptibility artefact predominantly centered on the basal ganglia with a few in the pons/cerebellum. There are a few supratentorial subcortical foci of susceptibility artefact but these are less prominent.
Case Discussion
This patient had a long history of chronic hypertension, and along with the pattern of microhemorrhages this represents chronic hypertensive encephalopathy.
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