Brain imaging course – Unknown case 3

Описание: This video is the 3rd unknown case that goes with the brain imaging capstone course.

If you want to follow along, you can find all the images for the case at the brain capstone website:
https://learnneuroradiology.com/brain...

0:00 Introduction

62 year-old male with new onset of left sided weakness, left facial droop and right eye pain

0:38 Interactive review

In this case, there is a CT showing a large hypderdense hemorrhage in the right parietal lobe. There is a lot of surrounding edema and mass effect, with effacement of the sulci, herniation from right to left, and complete effacement of the right lateral ventricle. The coronal and sagittal view confirm these findings.

This hemorrhage appears to be in the brain parenchyma, and the most common cause of a parenchymal hemorrhage is hypertension. You can also get hemorrhages from other causes such as cerebral amyloid angiopathy.

3:03 Case findings summary

A summary of the imaging findings is reviewed here.

3:36 Interactive question 3a

Vascular imaging in this patient is negative, what is the next step? The next step in this patient is neurosurgical consultation, as the patient is at high risk of herniation and death from the hemorrhage.

4:12 Companion case

This shows a similar case of hypertensive hemorrhage, only in this case there is extension of the hemorrhage into the ventricles, or intraventricular extension.

4:37 Interactive question 3b

What is the major potential complication in this companion case? Because of the intraventricular extension, the patient is at high risk of hydrocephalus, either from outflow obstruction or communicating hydrocephalus.

5:15 Diagnosis and Summary

This is a case of hypertensive hemorrhage. These mostly occur in older patients, with common locations being the thalamus, basal ganglia, pons, and cerebellum. You can get them in the cerebral hemispheres as in this case, although it is less common and you might think of other causes such as venous infarct or cerebral amyloid angiopathy. These cases are extremely common and one of the most common things we see in neuroradiology.

Thanks for tuning in to this case. There are a total of 7 cases you can review on your own at the website and explanations will be posted here. Be sure to check back in for additional videos in the future or check out the website at
https://www.learnneuroradiology.com