Presentation
Sudden loss of consciousness
Patient Data
Age: 75 years
Gender: Female
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Note is made of a large hyperdense hemorrhagic focus n the left temporal lobe with associated subarachnoid haemorrahage. Significant mass effect and midline shift to the right seen. Posterior fossa unremarkable.
Case Discussion
This case shows extensive intracranial hemorrhage. The patient died few hours later.
Although no aneurysm is visible on this non-contrast study, a left middle cerebral artery aneurysm is the most likely cause of this pattern of hemorrhage. The aneurysm dome can be adherent to brain (perhaps due to prior 'leaks') and when it ruptures some blood squirts directly into the parenchyma.
Other causes are of course possible (lobar hemorrhage, tumor, other vascular malformation).
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