Intracerebral hemorrhage

Case contributed by Gennaro D'Anna
Diagnosis certain


Stupor with difficulty to perform simple orders. Eyes closed. Patient on anti-coagulation therapy.

Patient Data

Age: 90 years
Gender: Male

Very large hyperdense intra-axial lobar hemorrhage occupying most of the right frontal lobe and extending into the ventricular system. At its maximum diameter, the hemorrhage measures 95 mm. It exerts marked positive mass effect, severely compressing the right lateral ventricle, with 12 mm of subfalcine herniation to the left.

As an additional finding, a chronic hypodensity in left precentral cortex is noted, likely representing an old infarct.

Case Discussion

This is a typical example of a large lobar intracerebral hemorrhage that exerts significant mass-effect. The hyperdensity of blood reflects the acute nature of the bleed.

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