Thalamic hematoma and intraventricular hemorrhage
Rapid deterioration of conscious level ending in coma of 2 days duration
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Acute left thalamic hematoma surrounded by toxic edema and extending to both lateral ventricles both subependymal and free blood. The blood demonstrates isointense signal on T1 with hyperintense periphery (subacute blood) and hypointense signal in T2 and T2*.
Associated ischemic changes are noted with scattered hypointense T2* foci from hemosiderin deposition.
The patient had chronic hypertension and renal failure then developed secondary amyloidosis. Amyloid deposition in blood vessels render them fragile and susceptible to rupture and hemorrhage.