Presentation
Found down at home. Last known normal 12 hours ago. Blown left pupil on physical exam.
Patient Data
CT non-contrast head:
There is a large intraparenchymal hemorrhage in the left thalamus and basal ganglia. There is
intraventricular extension with hemorrhage seen within the left lateral ventricle, bilateral occipital horns, third ventricle, and fourth ventricle.
The basal cisterns are effaced, left greater than right.
CTA head:
There is evidence of active hemorrhage within the left mesial temporal lobe. Given the location, this may be from the territory of the anterior choroidal artery or posterior cerebral artery.
Case Discussion
This is a case of non-traumatic hemorrhage within the brain. The active hemorrhage is seen as the "angiographic spot sign", indicating active extravasation of contrast within the site of hemorrhage.
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