Q: Where is the lesion likely to be found? show answer
Q: Why is timing important in a situation like this? show answer
Sudden onset dense left hemiparesis and loss of sensation. Previous subarachnoid haemorrhage. In scanner 2 hours from onset of symptoms.
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Right frontoparietal haemorrhage with surrounding oedema.
Mild mass effect with sulcal effacement. Basal cisterns clear with patent fourth ventricle.
Right sided ventricular access device in situ with tip sitting over third ventricle and prior anterior communicating artery aneurysm coil noted.
Normal venous drainage and no evidence of underlying AVM.
This is an example of a haemorrhagic stroke. Although hypertension is a common factor, in these lobar parenchymal haemorrhages, consideration should also be given to amyloid angiopathies.
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