Question 1791
{"accessible":true,"alternatives":[{"id":8896,"text":"anticoagulation"},{"id":8897,"text":"arteriovenous malformation"},{"id":8898,"text":"cavernous malformation"},{"id":8899,"text":"hemorrhagic transformation of an infarct"},{"id":8900,"text":"hypertension with spot sign"},{"id":8901,"text":"mycotic aneurysm"}],"archived":false,"correctAlternativeId":8901,"explanation":"\u003cp\u003eThe yellow arrow indicates a peripheral aneurysm in a good location for a \u003ca href=\"/articles/intracranial-mycotic-aneurysm\" title=\"Intracranial mycotic aneurysm\"\u003emycotic aneurysm\u003c/a\u003e. The history of cardiac surgery suggests the diagnosis of valvular repair for endocarditis, which was indeed the case in this instance.\u0026nbsp;\u003c/p\u003e\u003cp\u003eAn INR of 3.0 is not very high and consistent with anticoagulation for valve replacement.\u0026nbsp;\u003c/p\u003e\u003cp\u003eThere is no nidus of AV shunting to suggest a cerebral AVM and cavernomas are angiographically occult.\u0026nbsp;\u003c/p\u003e\u003cp\u003eHypertension usually presents a basal ganglia hemorrhages, not subarachnoid hemorrhage and \u003ca href=\"/articles/charcot-bouchard-aneurysm\" title=\"Charcot-Bouchard aneurysms\"\u003eCharcot-Bouchard aneurysms\u003c/a\u003e are usually not visible angiographically and arise from perforators, not MCA branches.\u0026nbsp;\u003c/p\u003e\u003cp\u003e\u003c/p\u003e","id":1791,"imageUrl":"https://prod-images-static.radiopaedia.org/multiple_choice_questions/281/2_big_gallery.jpeg","imageAttribution":{"kind":"case","rID":34439},"imageAttributionCaseInfo":{"title":"Subarachnoid hemorrhage and mycotic aneurysm","contributor_name":"Peter Mitchell","contributor_param":"mitchep","case_rid":34439,"case_param":"subarachnoid-haemorrhage-and-mycotic-aneurysm"},"firstQuestionPath":"/questions/2097","nextQuestionPath":"/articles/saccular-cerebral-aneurysm/questions/1457","relatedArticles":[{"id":6657,"title":"Brain arteriovenous malformation","link":"/articles/brain-arteriovenous-malformation?lang=us"},{"id":1064,"title":"Cerebral cavernous venous malformation","link":"/articles/cerebral-cavernous-venous-malformation?lang=us"},{"id":23452,"title":"Hemorrhagic transformation of ischemic stroke","link":"/articles/haemorrhagic-transformation-of-ischaemic-stroke?lang=us"},{"id":63362,"title":"Intracranial mycotic aneurysm","link":"/articles/intracranial-mycotic-aneurysm?lang=us"},{"id":24482,"title":"CT angiographic spot sign (intracerebral hemorrhage)","link":"/articles/ct-angiographic-spot-sign-intracerebral-haemorrhage?lang=us"}],"alsoUsedIn":[{"id":784,"kind":"Course","title":"Stroke Learning Pathway - page 784","link":"https://radiopaedia.org/courses/stroke-learning-pathway/pages/784"},{"id":2121,"kind":"Course","title":"Stroke Learning Pathway - peer review - page 2121","link":"https://radiopaedia.org/courses/stroke-learning-pathway-peer-review/pages/2121"}],"stem":"\u003cp\u003eA 65-year-old man day 7 after\u0026nbsp;cardiac surgery presents with sudden collapse and facial weakness. He has INR 3.0.\u0026nbsp;\u003c/p\u003e\u003cp\u003eWhat is the most likely cause of his hemorrhage?\u0026nbsp;\u003c/p\u003e","menuLinks":[{"text":"Report problem with question","url":"https://docs.google.com/forms/d/e/1FAIpQLSfO3soWYhOjJ7yErSysyCe5V4A1CqW7WK3rDA7MtAkecMGqNw/viewform?entry.1624461248\u0026entry.553583435=https://radiopaedia.org/questions/1791"}],"attemptsPercentages":[{"alternativeId":"8896","percentage":12},{"alternativeId":"8900","percentage":3},{"alternativeId":"8901","percentage":69},{"alternativeId":"8899","percentage":5},{"alternativeId":"8897","percentage":8},{"alternativeId":"8898","percentage":5}],"promptToLogin":false,"questionManager":false,"articleId":"saccular-cerebral-aneurysm"}