Case Images
Case Notes
History
74 yo female with secondary coagulopathy presenting with acute CNS hemorrhageExam
Prior Study
T1-w pre and post MR sequences, MR flairDicom
Findings
| MR susceptibility (SWI) | Correct Answer | Your Answer |
|---|---|---|
|
There is evidence (positive susceptibility artifact) of acute or prior subarachnoid blood. |
Yes | NA |
|
There is evidence (positive susceptibility artifact) of acute or prior intraaxial hemorrhage. |
Yes | NA |
|
There is evidence (positive susceptibility artifact) of acute or prior intraventricular blood. |
Yes | NA |
|
There is evidence (positive susceptibility artifact) of acute subpial blood. |
No | NA |
|
There is evidence of multicentric sites of parenchymal hemosiderin consistent with: chronic hypertensive encephalopathy, cavernous angiomata, amyloid angiopathy, or prior radiotherapy. |
No | NA |
|
There is "blooming susceptibility artifact" over arteries consistent with recent thrombosis. |
No | NA |
|
There is "blooming susceptibility artifact" over cortical or deep veins consistent with recent thrombosis. |
No | NA |
|
There are multicentric sites of pial surface microhemorrhages (result of mainly diapedesis rather than overt hemorrhage); evident in herpes simplex encephalitis, microhemorrhage in hypo-coagulopathy states. |
Yes | NA |
|
Other significant imaging findings are present. |
No | NA |
Impression
Expert Answer
Late subacute and chronic subarachnoid blood products show progressively more blooming effects. Acute subarachnoid blood is evident SWI, but the degree of blooming is minimal.
Your Answer
Recommendations & Acuity
Recommendations
Expert Answer
Proceed with additional MR imaging sequences.
Your Answer
Acuity
Expert Answer
Emergent (Action Necessary now)
