Presentation
Difficulty in speaking for 3 hours
Patient Data
T1 isointense and T2 hyperintense signal lesion (3.3 x 2 cm) showing central diffusion restriction and peripheral rim of blooming artefact (in T2* GRE sequence) in the right inferior frontal gyrus. FLAIR demonstrates a fluid-fluid level posteriorly.
Mild surrounding vasogenic edema is noted.
The rest of the brain parenchyma is normal.
Case Discussion
The images demonstrate a hyperacute intraparenchymal hemorrhage, but no MRI detectable cause was identified. An underlying vascular malformation (most likely) or tumor are likely to be present (unless there were other systemic illnesses or factors that are currently unknown e.g. malignant hypertension, trauma, drug use).
In any case further assessment with angiography and follow-up imaging is required.