Presentation
Acute right hemiparesis.
Patient Data
Non-contrast CT of the brain demonstrates an acute intracerebral hemorrhage centered in the basal ganglia of the left hemisphere. There is extension into the left lateral ventricle (intraventricular hemorrhage), with blood-forming a cast of the lateral ventricle, and passing into the third ventricle. There is no hydrocephalus at this stage.
This diagram depicts the Charcot Bouchard microaneurysms arising from perforating lenticulostriate arteries. These aneurysms typically arise from arteries no larger than 300 micrometers in diameter.
Brain section photo credit:
- Source: wikimedia commons (file here)
- Author: John A Beal, 2005
- Permission: This file is licensed under the Creative Commons Attribution 2.5 Generic license (CC-BY).
Superimposed artery diagram: Frank Gaillard, 2012
Case Discussion
This type of bleed is characteristic of a basal ganglia hemorrhage secondary to hypertension.