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Subacute hemorrhagic stroke - enhancing

Case contributed by Frank Gaillard
Diagnosis almost certain

Presentation

This patient is from a nursing home. Right sided weakness developed rapidly a few weeks ago. Non contrast CT demonstrated low density region.

Patient Data

Age: 70 years
Gender: Female

CT brain

ct

A region of irregular peripheral enhancement involves the left lentiform nucleus and internal capsule. 

MRI brain

mri

MRI of the brain demonstrates the lesion to have signal consistent with blood (high T1 and T2 centrally, peripheral hemosiderin).

MRI brain (months later)

mri

The corticospinal tracts on the left demonstrates high T2 signal in the left cerebral peduncle with reduced volume. 

Case Discussion

This case demonstrates how vividly a resolving hematoma can enhance. 

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