Presentation
Stupor with difficulty to perform simple orders. Eyes closed. Patient on anti-coagulation therapy.
Patient Data
Very large hyperdense intra-axial lobar haemorrhage occupying most of the right frontal lobe and extending into the ventricular system. At its maximum diameter, the haemorrhage 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 haemorrhage that exerts significant mass-effect. The hyperdensity of blood reflects the acute nature of the bleed.
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