Basal ganglia haemorrhage
Found in the bathroom collapsed and unresponsive. GCS 9 with a dense right sided weakness. Past history of borderline hypertension.
Loading Stack -
0 images remaining
Left sided acute intracerebral haematoma, with its epicentre in the basal ganglia/external capsule. The haemorrhage extends into the intraventricular system. There is no subarachnoid haemorrhage.
There is partial effacement of the left lateral ventricle but no hydrocephalus or significant midline shift.
Mild generalised cerebral volume loss. Mild periventricular low attenuation in keeping with small vessel change.
The patient died 9 months after the ICH and underwent a post mortem. This showed an old haematoma in the left basal ganglia, extending to the insular cortex laterally and lateral ventricle medially.
There is severe small vessel disease throughout the cerebral hemispheres. Immunohistochemistry shows only occasional meningeal and parenchymal amyloid angiopathy.
- Pantoni L. Cerebral small vessel disease: from pathogenesis and clinical characteristics to therapeutic challenges. (2010) The Lancet. Neurology. 9 (7): 689-701. doi:10.1016/S1474-4422(10)70104-6 - Pubmed
- Charidimou A, Schmitt A, Wilson D, Yakushiji Y, Gregoire SM, Fox Z, Jäger HR, Werring DJ. The Cerebral Haemorrhage Anatomical RaTing inStrument (CHARTS): Development and assessment of reliability. (2017) Journal of the neurological sciences. 372: 178-183. doi:10.1016/j.jns.2016.11.021 - Pubmed