Intracranial hemorrhage

Case contributed by Elsayed Mohamed Elsayed Galbat
Diagnosis almost certain

Presentation

The patient presented with a deteriorated conscious level and confusion.

Patient Data

Age: 40 year old
Gender: Male
ct

Multiple hemorrhagic lesions involving the corpus callosum and cerebral white matter bilaterally with intraventricular extension. Linear hyperdensities smearing the dural reflections and interpeduncular cistern are suggestive of subarachnoid hemorrhage.

Case Discussion

In view of the clinical history, peripheral blood picture and bone marrow aspiration from the right iliac crest, this patient was diagnosed with acute promyelocytic leukemia. This disease can present with massive intracranial hemorrhage because of associated thrombocytopenia and treatment induced disseminated intravascular coagulopathy.

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