Hypertensive intracerebral haemorrhage

Case contributed by Dr Prashant Mudgal


Hypertensive male presented with loss of consciousness.

Patient Data

Age: 60
Gender: Male

There is a large hyperdense area of blood attenuation is seen involving the right corona radiata, external capsule, putamen and globus pallidus suggestive of intraparenchymal haemorrhage.

The haematoma is dissecting further into bilateral lateral ventricles, third ventricle, aqueduct and fourth ventricle.

The haemorrhage is surrounded by thin edema and causing mass effect evident by midline shift towards left.

Case Discussion

Nearly two-thirds of intracerebral haemorrhages are located in the basal ganglia. Large haematomas often extend beyond the putamen to include the globus pallidus and internal capsule.

Haematoma dissection (or extension) into the ventricular system occurs in about half the cases of hypertensive ICH and is associated with poor prognosis, particularly when IVH involves the fourth ventricle.

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Case information

rID: 26131
Published: 30th Nov 2013
Last edited: 17th Jan 2016
Tag: pm
Inclusion in quiz mode: Included

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