Found unresponsive in bed. GCS 8. Past history of COPD and angina (on aspirin)
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Large deep right sided acute intracerebral haematoma, with its epicentre in the thalamus. The haemorrhage extends into the intraventricular system. There is no subarachnoid haemorrhage.
There is marked dilatation of the entire ventricular system consistent with hydrocephalus. Mild midline shift to the left.
Mild generalised cerebral volume loss. Moderate periventricular low attenuation in keeping with small vessel change +/- transependymal CSF spread.
The patient died the same day as the ICH and underwent post mortem. This showed an extensive right sided cerebral haemorrhage centred in the thalamus and extending into the ventricular system, which is distended.
Throughout the cerebral and cerebellar white matter there is small vessel disease in the form of lipohyalinosis and arteriolosclerosis. Immunohistochemistry shows no significant vascular amyloid.
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