Demographics:
60 years old, Male
Indication:
Stroke patient with decreased alertness
Findings
- Large left frontal lobe/insular parenchymal hematoma centered in an area of hypoattenuation in the left MCA distribution
- Small volume subarachnoid extension of blood products overlying the left frontal lobe and extending into the left sylvian fissure
- Associated mass effect with left frontal sulcal effacement and 3 mm left to right midline shift
- Mild mass effect on the left lateral ventricle without hydrocephalus
- Area of encephalomalacia in the right frontal lobe, which may relate to a remote infarct or injury
Diagnosis
Hemorrhagic conversion of an MCA infarct
Sample Report
Large left frontal lobe/insular parenchymal hematoma centered in an area of hypoattenuation in the left MCA distribution, consistent with hemorrhagic conversion of a pre-existing left MCA infarct. The hematoma measures 4 x 3.5 x 4 cm (estimated blood volume 28 mL).
Small volume subarachnoid extension of blood products overlying the left frontal lobe and extending into the left sylvian fissure.
Associated mass effect with left frontal sulcal effacement and 3 mm left to right midline shift. No evidence of transtentorial or cerebellar tonsillar herniation.
Mild mass effect on the left lateral ventricle without hydrocephalus.
Discussion