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CT brain (non-contrast): There is a small, uniformly hyperdense, regularly-shaped ovoid haematoma within the left midbrain/left cerebral peduncle measuring 16 mm (ap) x 8.5mm (trans) x 11mm (cc), estimated volume using the ABC/2 rule about 1cc. There is a surrounding rim of hypoattenuation in keeping with vasogenic oedema that extends as inferiorly as the left side of the pons and superiorly as the posterior limb of the left internal capsule, compatible with evolving vasogenic oedema no additional focus of intracranial haemorrhage is identified. No evidence of acute ischaemia. Ventricles, cisterns and sulci are within normal limits for age. No hydrocephalus or midline shift. No calvarial fracture suspicious bony abnormality seen. Opacification of several ethmoid air cells. Other paranasal sinuses and mastoid air cells are clear.
CTA Circle of Willis (not shown): No vascular abnormality is identified in the region of the left midbrain haemorrhage. There is no evidence of the CT angiographic 'spot sign' to suggest dynamic haemorrhage at the time of examination.
Small left midbrain intracerebral haemorrhage with surrounding halo of vasogenic oedema, with no hydrocephalus. An underlying lesion is suspected (e.g. cavernoma or tumour)