Case Notes
History
36 yo female with history of drug abuse who fell out of bed and remained unconscious.Exam
CTA and DSA
Prior Study
CT head:1. Combined acute intraaxial and subarachnoid hemorrhage within the right insula and adjacent distal (parainsular) sylvian fissure.
2. Apparent post ischemic cytogenic tissue edema in the distribution of the superior division right MCA perfusion zone.
3. Right hemispheric mass effect with 6 mms of subfalcine shift plus asymmetric right downward incisural uncal herniation.
4. Early hydrocephalus affects the right temporal horn from ipsilateral trigonal compression, and the contralateral left lateral ventricle, as a result of the subfalcine shift.