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Intracranial hemorrhage with fluid-fluid level

Case contributed by Mohammad Farghali Ali Tosson
Diagnosis certain

Presentation

Left sided hemiplegia, on anticoagulation therapy.

Patient Data

Age: 55 years
Gender: Male

Intracranial hemorrhage in the right insular and external capsule regions, associated with mild peripheral edema, resulting in mass effect upon the ipsilateral lateral ventricle. A fluid-fluid level is evident that may be associated with bleeding from a coagulation disorder or anticoagulation.

Case Discussion

Fluid-fluid level (aka blood-fluid level) or sedimentation level or hematocrit effect, in intracranial hemorrhage can be seen on CT or MRI. This is associated with patients who have coagulopathy or who are receiving anticoagulation therapy. These can prevent the formation or lysis of a blood clot, resulting in this appearance. 

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