Findings
- Large left frontoparietal parenchymal hematoma measuring 7 x 4 x 5 cm with intraventricular extension and surrounding vasogenic edema resulting in 0.5 cm left to right midline shift
- Right occipital parenchymal hematoma measuring 2 x 1.5 x 2.5 cm, which appears to extend into the subarachnoid space
- Scattered small volume subarachnoid hemorrhage
- Asymmetric enlargement of the temporal horn of the left lateral ventricle
- Heavily calcified intracranial atherosclerosis
- Partially imaged endotracheal tube
Diagnosis
Hemorrhage secondary to amyloid angiopathy
Sample Report
Large left frontoparietal parenchymal hematoma measuring 7 x 4 x 5 cm (estimated blood volume 70 mL) with intraventricular extension and surrounding vasogenic edema resulting in 5 mm left to right midline shift. No evidence of herniation. Smaller right occipital parenchymal hematoma measuring 2 x 1.5 x 2.5 cm, which appears to communicate with the subarachnoid space. Given the multifocality of these hematomas, the primary differential considerations are hemorrhagic conversion of infarcts (e.g. cardioembolic), hemorrhagic metastases, and amyloid angiopathy.
Scattered small volume subarachnoid hemorrhage.
Asymmetric enlargement of the temporal horn of the left lateral ventricle, which raises concern for entrapment.
Heavily calcified intracranial atherosclerosis.
Discussion