Case Images
Case Notes
History
56 yo female with chronic hypertension and recent cerebellar symptomsExam
Prior Study
noneDicom
Findings
| Pre contrast head CT | Correct Answer | Your Answer |
|---|---|---|
|
There is evidence of acute diffuse subarachnoid blood (SAH) or there is focal clot near a site of expected saccular aneurysm. |
No | NA |
|
There is evidence of acute intraaxial parenchymal blood. |
Yes | NA |
|
There is evidence of acute intraventricular blood. |
No | NA |
|
There is evidence of significant mass effect from the parenchymal hemorrhage. |
No | NA |
|
There is evidence of secondary internal or external obstructive hydrocephalus. |
No | NA |
|
There is evidence of an underlying post ischemic tissue edema in a recognizable arterial perfusion zone (i.e. arterial infarction). |
Yes | NA |
|
There is evidence of blood products within the sella (hemorrhagic pituitary or ICA aneurysm). |
No | NA |
| Post contrast head CT or CTA | Correct Answer | Your Answer |
|---|---|---|
|
There is evidence of an underlying extraaxial vascular lesion: saccular aneurysm, sacculofusiform aneurysm, dural sinus thrombosis. |
No | NA |
|
There is evidence of an underlying intraaxial mass(es) lesion, as primary vascular brain tumor, metastatic tumor, AVM, cavernous angioma, thrombosed giant aneurysm. |
No | NA |
|
There is evidence of acute thrombus within intracranial veins. |
No | NA |
|
There is evidence of acute thrombus within intracranial arteries. |
Yes | NA |
|
Other significant imaging findings are present. |
Yes | NA |
Impression
Expert Answer
Any focal parenchymal hyperdense lesion on CT that looks like acute hemorrhage may have a different cause. Evaluation of the area adjacent to the apparent hemorrhage should be surveyed especially for post ischemic and tumoral lesions that can produce focal nodular calcifications. Focal apparent parenchymal hyperdensity plus associated acute SAH or intraventicular blood will indicate that the parenchymal lesion is likely acute hemorrhage as well.
Your Answer
Recommendations & Acuity
Recommendations
Expert Answer
Proceed with additional MR imaging sequences.
Your Answer
Acuity
Expert Answer
Emergent (Action Necessary now)
