Case Notes
History
26 yo male with history of IV drug use presenting with symptoms of possible intracerebral hemorrhage; there is prior history of MRSA endocarditis and tricuspid valve vegetation. CSF no organism was cultured.Exam
Post contrast head CTA
Prior Study
Noncontrast CT1. Acute caudal cerebellar hemorrhage plus adjacent premedullary subarachnoid hemorrhage are consistent with an aneurysm that likely has previously bled (sentinel hemorrhage causing arachnoid adhesions), which upon subsequent bleeding, has resulted in mainly an intraaxial hemorrhage directly into the adjacent brain.
2. Acute obstructive grade 1/4/4 hydrocephalus
3. There is significant upward transtentorial herniation.