Basal ganglia and thalamic hemorrhage with intraventricular extension
Diagnosis certain
Presentation
Headache, left hemiparesis in a known hypertensive.
Patient Data
Age: 70 years
Gender: Female
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Axial non contrast CT demonstrates an acute intracerebral hemorrhage with perilesional edema centered in the right basal ganglia and thalamus. There is extension into the lateral, third and fourth ventricles (intraventricular hemorrhage) with associated hydrocephalus and transependymal seepage of CSF. The sulci, gyri and ipsilateral lateral ventricle are effaced. Significant midline shift to the left is noted.
Case Discussion
Hypertension is the most common cause of intracerebral hemorrhage. Typical locations include:
- basal ganglia
- thalami
- pons
- dentate nucleus of the cerebellum
CT findings are consistent with hypertensive basal ganglia and thalamic hemorrhage with intraventricular extension and consequential obstructive hydrocephalus.
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