Presentation
Acute onset left weakness of face, arm and leg.
Patient Data
Large intraparenchymal hemorrhage centered in the right lentiform nucleus and external capsule. Mild mass effect with effacement of the right lateral ventricle. 3 mm of midline shift. No herniation.
No vascular malformation or aneurysm identified. No vascular beading or irregularity to suggest vasculitis. The right lentiform nucleus hemorrhage contains 3 small focal arterial blushes (CTA spot sign).
No change in hameorrhage size or mass effect.
No aneurysm, vascular malformation, dissection or evidence of dysplasia.
Case Discussion
This patient is a known ice (methamphetamine) user and was taking the drug when he experienced an acute onset headache and weakness. He is not known to be hypertensive and blood pressure during admission was within normal limits.