Combined traumatic and hypertensive hemorrhage

Case contributed by Andrew Dixon
Diagnosis almost certain

Presentation

Driver in car accident. Reduced GCS.

Patient Data

Age: 65 years
Gender: Male

There are multiple intraparenchymal hemorrhages, the largest of which is centered within the left basal ganglia consistent with hypertensive etiology. The remaining smaller hemorrhages are located at the grey-white junction in the right frontal lobe and temporal lobe consistent with traumatic etiology. 

Case Discussion

This case is radiologically cute in that the intraparenchymal hemorrhages have two separate etiologies. The patient most likely suffered a left basal ganglia hypertensive bleed whilst driving and then crashed his car receiving traumatic right frontal and temporal hemorrhages.   

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