File:Cerebral amyloid angiopathy- multiple intracranial hemorrhages (Radiopaedia 40475-43052 A 11).png

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Cerebral_amyloid_angiopathy-_multiple_intracranial_hemorrhages_(Radiopaedia_40475-43052_A_11).png ‎(512 × 583 pixels, file size: 98 KB, MIME type: image/png)

Summary:

Description
  • Radiopaedia case ID: 40475
  • Image ID: 16762281
  • Image stack position: 11/36
  • Plane projection: Axial
  • Aux modality: C+ arterial phase
  • Study description: CTA Brain (5 days later) - Sudden drop in GCS
  • Study findings: New large left frontoparietal parenchymal hemorrhage (54 x 34 x 55 mm results in midline shift to the right of 6 mm (previously there was no midline shift). This appears separate to the previous left frontal hemorrhage. There is also further subarachnoid hemorrhage at the vertex. No CTA spot sign. Normal aortic arch anatomy. Common carotid and internal carotid arteries are patent with no dissection. Vertebral arteries are patent with no dissection. Normal circle of Willis anatomy. No aneurysms, filling defects or vascular malformations are identified. ETT positioned appropriately. Apical subpleural blebs. Nasogastric tube is noted. Conclusion: Large left frontoparietal parenchymal hemorrhage with subarachnoid extension has developed since the CT at 09:56 this morning with new midline shift to the right. No basilar artery thrombus.
  • Modality: CT
  • System: Central Nervous System
  • Findings: A relatively stable ill-defined 2 cm area of gliosis/encephalomalacia and hemosiderin staining, compatible with old hemorrhage, remains centered posteriorly in the left inferior and middle temporal gyri. There is no evidence of underlying tumor, vascular malformation or aneurysm. Of note, a linear focus of T2 hyperintensity and diffusion restriction, consistent with a recent small vessel infarct , is now noted to course obliquely through the posterior left parietal lobe subcortical white matter. A stable 2-3 cm area of partly liquefied encephalomalacia/gliosis remains centered inferiorly in the left occipital lobe, with moderately extensive chronic small vessel ischemic change elsewhere in the white matter of both cerebral hemispheres and brainstem considered excessive even for a 62 year old patient.The remainder of the study is unremarkable.
Date Published: 24th Oct 2015
Source https://radiopaedia.org/cases/cerebral-amyloid-angiopathy-multiple-intracranial-haemorrhages
Author RMH Neuropathology
Permission
(Permission-reusing-text)		 http://creativecommons.org/licenses/by-nc-sa/3.0/

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