Presentation
Sudden loss of consciousness and coma. The patient is a known hypertensive.
Patient Data
Large right temporal intracerebral acute hematoma with right basal ganglionic extension and subependymal haemorrahge of the ipsilateral lateral ventricle. Associated marked mass effect is noted in form of uncal herniation with compression of the brain stem against the contralateral tentorial edge.
The midbrain and pons show large parenchymal hemorrhage which extends to the 4th ventricular cavity.
Case Discussion
The large right temporal and basal ganglionic hypertensive hematoma causes uncal herniation and damage to the perforating branches of the basilar artery and consequently brainstem parenchymal hemorrhage (Duret hemorrhage) which is fatal and of bad prognosis.