Hemorrhagic stroke

Case contributed by Derek Smith
Diagnosis certain

Presentation

Sudden onset dense left hemiparesis and loss of sensation. Previous subarachnoid hemorrhage. In scanner 2 hours from onset of symptoms.

Patient Data

Age: 70 years
Gender: Male
ct

Right frontoparietal hemorrhage with surrounding edema.

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.

Case Discussion

This is an example of a hemorrhagic stroke. Although hypertension is a common factor, in these lobar parenchymal hemorrhages, consideration should also be given to amyloid angiopathies.

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