File:Cerebral amyloid angiopathy and lobar hemorrhage (Radiopaedia 24877-25133 Gradient Echo 17).jpg

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Summary:

Description
  • Radiopaedia case ID: 24877
  • Image ID: 4700933
  • Image stack position: 17/19
  • Aux modality: Gradient Echo
  • Study findings: Right parietal craniotomy and evacuation of the right temporoparietal hematoma  with evacuation of much of the hematoma. There is persistent gyral swelling and sulcal effacement throughout the right temporal, parietal and occipital lobes with mild compression of the right lateral ventricle but no midline shift.   Foci of deep and periventricular white matter hyperintensity likely represents chronic small vessel ischemic change. Poorly seen due to motion degradation, are a number of small punctate regions of signal drop out on EPI suggestive of microhemorrhages. They are peripeheral in distribution. No enhancing lesion seen within the region of the hematoma. The overlying dura is slightly thickened and enhancing in keeping with the recent postoperative state. MRA (not shown) demonstrates no malformation, aneurysm, stenosis or other vascular abnormality. Conclusion: Location and presence of microhemorrhages suggests a lobar hemorrhage secondary to cerebral amyloid angiopathy.
  • Modality: MRI
  • System: Central Nervous System
  • Findings: There is a large right parietal/temporo/occipital/temporal hematoma measuring approximately 5.4cm x 3.7m with a large amount of surrounding edema. There is significant mass-effect, characterized by right cortical sulcal effacement, compression of the right lateral and third ventricles, right uncal herniation and 8mm of leftward midline shift. Temporal horn dilatation is consistent with early hydrocephalus. CTA COW (not shown) The extracranial vessels, circle of willis and vertebrobasilar system opacify normally.  No evidence of aneurysm, vascular malformation, dissection or significant stenosis.
Date Published: 17th Sep 2013
Source https://radiopaedia.org/cases/cerebral-amyloid-angiopathy-and-lobar-haemorrhage
Author RMH Neuropathology
Permission
(Permission-reusing-text)		 http://creativecommons.org/licenses/by-nc-sa/3.0/

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